Babies who develop viral respiratory infections in their first six months face an increased risk of type 1 diabetes as they grow older, according to a German study.
A study conducted by scientists at the Helmholtz Zentrum München, Germany, say their findings provide a further piece in the puzzle in understanding how type 1 diabetes develops.
Before this study, there were only inconsistent indications from studies with children with a genetically higher risk of type 1 diabetes regarding the influence of infections.
However, the team examined anonymised data from almost 300,000 children born in Bavaria between 2005 and 2007, which represents about 85% of all new-borns in the region during those years.
They evaluated all available data on infections, breaking them down to localised symptoms, such as dermal, eye, gastrointestinal or respiratory infections, whether the cause was bacterial, viral or mycoses, and the babies’ ages.
Prof Dr Anette-Gabriele Ziegler, director of the Institute of Diabetes Research (IDF) at Helmholtz Zentrum München, who led the study, said: “Now for the first time we were able to confirm this in a population-based dataset of almost 300,000 children. In particular, we found strong indications that the first six months are an especially sensitive stage in life.
“This is also consistent with other results that we have published based on data from children with increased familial risk, which already suggested that the first half year of life is crucial for the development of the immune system and of autoimmune diseases such as type 1 diabetes.”
The research, which is published in JAMA, found that infections that occurred later or that involved other organs were not associated with a significantly higher risk.
* Researchers have quantified for the first time a patient’s risk of developing diabetes if they take a common steroid for rheumatoid arthritis (RA).
According to the University of Manchester team, the risk of developing diabetes when taking glucocorticoids, which is prescribed to about half of RA patients, increases in relation to the dosage, duration and timing of steroids.
The researchers reveal their findings after examining the records of 21,962 RA patients and looking at rates of new-onset diabetes, comparing those who were prescribed glucocorticoids and those who were not.
Writing in Arthritis and Rheumatology, they say that glucocorticoids were associated with one new case of diabetes for every 150-200 people treated per year.
Within this group, risk was affected by the dose only in the most recent six months, with each increase of 5mg prednisolone per day carrying a 25-30% increase in diabetes. Doses under 5mg were not associated with a measurable risk of diabetes.
The results were also checked against 12,657 USA-held records.
Lead author Dr Will Dixon, director of the Arthritis Research UK Centre for Epidemiology at The University of Manchester and Honorary Consultant Rheumatologist at Salford Royal NHS Foundation Trust, said: “Until now, no studies have considered how the risk changes with the dose and duration of treatment. This research provides important evidence for doctors to make this decision.”
He added: “This research shows that low doses of steroids (below 5mg/ day) do not increase the risk of diabetes. However, there is an increased risk of acquiring diabetes for people who use them for long periods or at high doses which can now be quantified.”
The research does not recommend that people stop using glucocorticoids.
Beyerlein, A. et al. (2016). Infections in early life and development of type 1 diabetes. JAMA. May 2016. doi: 10.1001/jama.2016.2181
Movahedi M, Beauchamp M-E, Abrahamowicz M et al. Risk of Incident Diabetes Associated with Dose and Duration of Oral Glucocorticoid Therapy in Patients with Rheumatoid Arthritis. Arthritis and Rheumatology. DOI: 10.1002/art.39537
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