Environmental Factors and the Risk of Type 1 Diabetes Mellitus-A Case-Control Study

Abstract

Introduction: An interaction between genetic susceptibility and environmental factors is assumed to be elaborate in the etiology of type 1 diabetes mellitus (T1DM). Autoimmunity may be induced in first years of life, suggesting that environmental agents encountered early in life could be triggers of the disease process. Aim: The aim of the study was therefore to investigate the associations of T1DM with several environmental factors. Methods: A case-control study was conducted in Minia University Maternity and Children Hospital, Minia governorate, Egypt. One hundred and ten children aged from 2-16 years old who were diagnosed with T1DM and 110 age and sex-matched controls were included. Data regarding environmental factors during gestation, neonatal period, and early years of life were collected by a structured questionnaire. Results: On multivariable logistic regression analysis, maternal age >35 years at delivery, the presence of gestational diabetes, pre-eclampsia and taking medications during pregnancy were significantly associated with the occurrence of T1DM. Also, viral infection in early life, low birth weight children (<2500 grams) and those who suffered from neonatal diseases (respiratory distress, jaundice, and infection) were 4.71 and 2.17 folds increased therisk of T1DM. Consumption of cow's milk during the1st year of life was a significant predictor for developing T1DM with OR 3.83 (1.64-8.96), However, vitamin D supplement and increased duration of breast feeding were significant protective factors. Conclusion: in the present study, certain environmental risk factors were associated with the development of T1DM.