Antibiotics in early childhood linked to slightly increased T1D risk

  • Wernroth ML & al.
  • Diabetes Care
  • 4 Mar 2020

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Antibiotic prescription in the first year for acute otitis media or upper respiratory tract infections is linked to a slightly increased risk for type 1 diabetes (T1D).
  • Maternal exposure during pregnancy is also tied to slightly increased risk.
  • Risks were not always significant in sibling-controlled analyses.

Why this matters

  • Some studies have suggested an association of antibiotics exposure and T1D risk.

Key results

  • 23.8% were prescribed antibiotics as infants.
  • Their T1D risk vs those not prescribed antibiotics: adjusted HR, 1.19 (95% CI, 1.05-1.36).
    • Cesarean delivery intensified this effect.
  • Sibling analyses yielded similar associations, although dulling their significance.
  • An association of antibiotics for acute otitis media and upper respiratory tract infections was significant in both total and sibling analyses.
    • Lactamase-sensitive penicillin was prescribed for 72% and showed an association with T1D (adjusted HR, 1.23; 95% CI, 1.06-1.42).
  • For perspective, 1475 children would have to have antibiotic exposure to add 1 T1D case among children under age 9 years.
  • Prenatal exposure was also linked to increased T1D risk: adjusted HR, 1.15 (95% CI, 1.00-1.32).

Study design

  • Study included 797,318 singletons born in Sweden between July 1, 2005 and September 30, 2013.
  • Funding: Swedish Research Council; others.

Limitations

  • No information about breastfeeding.
  • Types of infection not specifically known.