Month of Birth and Subsequent Development of Type I Diabetes (IDDM)

Laron, Zvi; Shamis, Igor; Nitzan-Kaluski, Dorit; Ashkenazi, Israel

doi:10.1515/jpem.1999.12.3.397

Cited by 31 publications

(22 citation statements)

References 19 publications

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“…Our search for significant sea- Rothwell et al (1996) report [12], b data from Spain exclude patients born on the 1st of January as that date was over-represented in the set and we assume that it was used to substitute the missing value for date of birth sonality of birth in populations of patients with childhood onset Type I diabetes in 14 European regions outside of Great Britian failed to find any evidence of a seasonal pattern. The grouping of countries into areas of high, medium and low incidence did not show any degree of seasonal effect [17] although differences between high and low incidence groups have been observed in Israel [14].…”

Section: Discussionmentioning

confidence: 77%

“…In 1996, an investigation of a large cohort of children with Type I diabetes from Scotland, Yorkshire and England and Wales in Great Britain found a statistically significant asymmetry in the monthly birth patterns of children who develop Type I diabetes compared with the monthly birth patterns of the background population [12]. Seasonality of birth has also been observed in Sweden [13], in Israel, among Jews [14], and in the Netherlands where differences between males and females have been found [15].…”

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confidence: 99%

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Seasonality of birth in patients with childhood Type I diabetes in 19 European regions

McKinney

2001

Diabetologia

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Season of birth appears to be associated with the development of many diseases, including conditions not generally thought to be season-dependent [1].The experiences of the growing fetus and neonate are thought to affect future susceptibility to diseases [2]. Systematic cyclical variations in the patterns of births could reflect environmental factors which also have cyclical variations.The cause of childhood Type I (insulin-dependent) diabetes mellitus is still not clear. Genetic susceptibility accounts for only a small proportion of the possible determinants [3] and non-genetic factors therefore play an important role. After analysing sets of data from different countries, several studies have identified a number of environmental risk factors for the development of Type I diabetes, particularly Diabetologia (2001) Abstract Aims/hypothesis. Differences in seasonality of birth patterns between the general population and the group who develop Type I (insulin-dependent) diabetes mellitus indicate that environmental factors operating around the antenatal and perinatal period could be important. We investigated whether the same unsual patterns in seasonality of birth observed in children with Type I diabetes in Great Britain could also be found in other European populations. Methods. Population-based incidence cohorts of children diagnosed with Type I diabetes under 15 years of age from 1989 onwards were analysed. Previously reported data sets from Great Britain were also included together with data on children diagnosed over an additional 5 year period (1988±1992). To assess the role of seasonality in diabetes, we used the method of Walter and Elwood to examine monthly birth figures for each country or region. Results. Outside of Great Britain, no seasonality of birth was seen for any single or combination of European countries. Significant sinusoidal patterns were observed in Scotland, Yorkshire and Leicester, although the peak for Leicester appeared around autumn rather than spring. There was little evidence that sex or age at diagnosis played a part in differences in seasonal patterns, either overall or for any individual country. Conclusions/interpretation. We found no uniform seasonal pattern of birth in childhood diabetes patients across European populations, either overall or according to sex and age. This study provides no consistent evidence that environmental factors, which vary from season to season, have any influence on the fetal or neonatal life to determine the onset of Type I diabetes. However, a study of seasonality that takes into account possible changes both over time and over geographical areas could provide more insights. [Diabetologia (2001)

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Section: Discussionmentioning

confidence: 77%

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confidence: 99%

Seasonality of birth in patients with childhood Type I diabetes in 19 European regions

McKinney

2001

Diabetologia

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“…One might assume that autoimmune diseases haveddespite different antigens and antibodiesda common trigger in the initiation of an autoimmune process such as viral infections or vitamin D level in the fetal or perinatal period (25). In a series of epidemiologic studies performed in different populations, it has been reported that children and adolescents with type 1 diabetes or autoimmune diseases such as celiac disease and thyroiditis have a different rhythmic pattern of month of birth (25)(26)(27)(28)(29). In an Australian study, there was an inverse correlation between ambient ultraviolet radiation in the first trimester and risk of MS (30).…”

Section: Discussionmentioning

confidence: 99%

Higher Relative Risk for Multiple Sclerosis in a Pediatric and Adolescent Diabetic Population: Analysis From DPV Database

Bechtold¹,

Blaschek²,

Raile

et al. 2013

Diabetes Care

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OBJECTIVEType 1 diabetes and multiple sclerosis (MS) are typical autoimmune diseases in children and young adults. We assessed the co-occurrence of type 1 diabetes and MS by estimating the relative risk (RR) for MS in a pediatric and adolescent diabetic population and looked for possible influencing factors. RESEARCH DESIGN AND METHODSWithin the Diabetes Patienten Verlaufsdokumentation (DPV)-Wiss Project, from January 1995 to October 2012, data from 56,653 patients with type 1 diabetes were collected in 248 centers in Germany and Austria. Published data on German and Mid-European MS prevalence were taken for comparison. Multivariable regression analysis was used to identify confounders for co-occurrence of type 1 diabetes and MS. RESULTSThe RR for MS in patients with type 1 diabetes was estimated at 3.35-4.79 (95% CI 1.56-7.21 and 2.01-11.39, respectively). Immigration status in all patients (P < 0.05) and the presence of thyroid antibodies in male patients only (P = 0.05) were identified as influencing factors on MS incidence within the DPV database. The month-of-birth pattern revealed that risk was higher during the spring and summer months in the population with type 1 diabetes and MS in comparison with the population with type 1 diabetes. CONCLUSIONSThe present cohort study demonstrates a higher risk of co-occurrence of MS in a pediatric and adolescent diabetic population. Immigration status and thyroid antibodies in male patients were independent risk indicators for the incidental rate of MS. Diabetic patients born during spring and summer had a higher risk for the development of MS. We suggest that environmental factors modulate the individual's risk for the co-occurrence of both diseases.

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“…This mechanism may explain the low incidence of T1DM in certain populations and the lack of seasonality of birth in them [Ye Chen et al, 1998; Figure 2. Opposing seasonalities of month of onset of disease and month of birth of the same cohort of Israeli Yemenite Jewish children (0-17 years) with Type 1 diabetes mellitus [data from Laron et al, 1998]. Kida et al, 2000;Collado-Mesa et al, 2001].…”

Section: Initiation Of the Autoimmune Process Of Type 1 Diabetes Begimentioning

confidence: 99%

Interplay between heredity and environment in the recent explosion of type 1 childhood diabetes mellitus

Laron

2002

Am. J. Med. Genet.

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The fast increase in the incidence of childhood type 1 diabetes mellitus (T1DM) that cannot be explained by changes in the genetic susceptibility, led us to look for environmental causes. To test the hypothesis that the initiation of the autoimmune process of childhood T1DM in genetically susceptible subjects begins in the perinatal period by a viral infection, we studied the seasonal variations in the month of birth of several cohorts of patients compared to the general population. Population groups with high or low T1DM incidence were analyzed separately by t-test and the Cosinor methods. In areas with populations with a high incidence (Israeli Jews, Sicily, Sardinia, Slovenia, Germany) we found that the children (in Sicily also young adults) who subsequently developed T1DM, have a higher incidence of births in the summer months than in other seasons of the year, a mirror image of the seasonality of the clinical onset of disease. This pattern differed significantly from the seasonality of the total live births in the same populations. In populations with a low T1DM incidence, (China, Japan and Cuba) no seasonality of month of birth was found. Similar findings have been reported, from five counties in the U.K. and the Netherlands. It is hypothesized that mothers who become pregnant during the period of yearly viral epidemics transmit to the fetus, either a virus or antiviral antibodies, which determine whether an autoimmune process against the pancreatic beta is initiated or whether the fetus is protected against that process.

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Month of Birth and Subsequent Development of Type I Diabetes (IDDM)

Cited by 31 publications

References 19 publications

Seasonality of birth in patients with childhood Type I diabetes in 19 European regions

Seasonality of birth in patients with childhood Type I diabetes in 19 European regions

Higher Relative Risk for Multiple Sclerosis in a Pediatric and Adolescent Diabetic Population: Analysis From DPV Database

Interplay between heredity and environment in the recent explosion of type 1 childhood diabetes mellitus

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