Use of antimicrobials and risk of type 1 diabetes in a population-based mother–child cohort

Abstract

Aims/hypothesis: The aim of this study was to investigate whether the use of antimicrobials is associated with the risk of childhood type 1 diabetes. Materials and methods: The study population included all children born in Finland between 1996 and 2000 who were diagnosed with type 1 diabetes by the end of 2002. For each case (n=437), four matched controls were selected. Data on diabetes and the maternal use of antimicrobials was derived from nationwide registries. Results: Maternal use of phenoxymethyl penicillins (odds ratio [OR]=1.70, 95% CI 1.08-2.68, p=0.022) or quinolone antimicrobials (OR=2.43, 95% CI 1.16-5.10, p=0.019) before pregnancy was associated with an increased risk of type 1 diabetes in the child, whereas the use of other specific antimicrobials was not related to the risk. The risk was also higher among mother-child pairs where macrolides were used both by the mother before pregnancy and by the child, compared with pairs where neither used macrolides (OR=1.76, 95% CI 1.05-2.94, p=0.032). Maternal use of antimicrobials during pregnancy was not associated with an increased risk. The high use of antimicrobials by the child (more than seven vs seven or less purchases) was related to greater risk (OR=1.66, 95% CI 1.24-2.24, p=0.001). Conclusions/ interpretation: Overall, the use of antimicrobials before pregnancy, during pregnancy or during childhood was not related to the risk of childhood type 1 diabetes. However, the use of some specific antimicrobials by the mother before pregnancy and by the child may be associated with an increased risk. Further studies are needed to confirm these associations and to elucidate the underlying mechanisms of action.

Viral Trigger for Type 1 Diabetes

“…It is also interesting to note that many type 1 diabetic patients are first born of large families, possibly indicative of lower exposure to infections. In addition, while congenital infections have been proposed to account for type 1 diabetes development in the offspring, the use of antimicrobials by mothers before pregnancy and subsequently by the child was suggested to be associated with higher risk for type 1 diabetes (29). Increased diabetes incidence in the Western world may thus be reflective of the "ultra-clean living" phenomenon.…”

Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents

“…To date, there has been little agreement on the association between anti-infective use and risk of developing type 1 diabetes (29)(30)(31). According to Kilkkinen et al, the use of phenoxymethyl penicillins and quinolones by mothers before pregnancy and the use of macrolides by mothers before pregnancy and by their child were associated with an increased risk of type 1 diabetes in children (31).…”

“…To date, there has been little agreement on the association between anti-infective use and risk of developing type 1 diabetes (29)(30)(31). According to Kilkkinen et al, the use of phenoxymethyl penicillins and quinolones by mothers before pregnancy and the use of macrolides by mothers before pregnancy and by their child were associated with an increased risk of type 1 diabetes in children (31). Furthermore, a recent FDA warning about fluoroquinolone antibiotics mentioned that several drugs in this class of antibiotics may disrupt blood glucose control in individuals with diabetes because of the insulinotropic or other effects of fluoroquinolones on beta cells in the pancreas.…”

The state of oral health in children with diabetess mellitus type 1 in Montenegro

“…Takav je slučaj kod hroničnog alkoholizma, raznih endokrinih poremećaja (akromegalija, hipertireoza, Kušingov sindrom), virusnih oboljenja (posebno Coxacki B 4 , Rubeola, Parotitis), upale ili karcinoma pankreasa i ishrane kravljim mlekom (bovine belančevine i bovin insulin prisutan u mleku), nedostatak vitamina D i dr [17][18][19][20][21] .…”

“…Lekovi mogu uticati na pojavu šećerne bolesti, a to su antihipertenzivi, diuretici, oralni kontraceptivi, kortikosteroidi, antibiotici (hinolini) 18 .…”