M. Hummel et al., No major association of breast-feeding, vaccinations, and childhood viral diseases with early islet autoimmunity in the German BABYDIAB study, DIABET CARE, 23(7), 2000, pp. 969-974
OBJECTIVE - Environmental factors have been suggested to play an important
role in the pathogenesis of type 1 diabetes. The aim of this study was to a
ssess the influence of breast-feeding, vaccinations, and childhood viral di
seases on the initiation of islet autoimmunity in early childhood.
RESEARCH DESIGN AND METHODS - Data were prospectively collected from questi
onnaires obtained at birth, at 9 months of age, and at 2 years of age in 82
3 offspring from parents with type 1 diabetes. By 2 years of age, 31 offspr
ing had islet antibodies, and 10 developed overt diabetes by the time of fo
llow-up.
RESULTS - In offspring from mothers with type 1 diabetes, duration of exclu
sive and total breast-feeding did not differ between islet antibody-positiv
e and -negative children, regardless of HLA genotype, and breast-feeding of
3 months or longer was not associated with protection from antibody develo
pment or diabetes onset. In offspring from diabetic fathers, non-statistica
lly significant reductions in exclusive and total breast-feeding times were
observed in the antibody-positive cohort. Neither type nor quantity of vac
cinations (including Bacille Calmette-Guerin vaccine; haemophilus influenza
e vaccine; diphtheria, tetanus, and pertussis vaccine; tick-born encephalit
is vaccine; or measles, mumps, and rubella vaccine) were associated with th
e development of islet antibodies and diabetes. Measles, mumps, and rubella
were not reported in children with islet antibodies or diabetes.
CONCLUSIONS - This study showed no evidence that proposed environmental fac
tors affect islet antibody development in the first 2 years of life in offs
pring from parents with type 1 diabetes.