Short communication

Diabetologia

, Volume 49, Issue 1, pp 66-70

First online:

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

  • A. KilkkinenAffiliated withDepartment of Epidemiology and Health Promotion, National Public Health Institute Email author 
  • , S. M. VirtanenAffiliated withDepartment of Epidemiology and Health Promotion, National Public Health InstituteTampere School of Public Health, University of TampereResearch Unit, Tampere University Hospital
  • , T. KlaukkaAffiliated withSocial Insurance Institution
  • , M. G. KenwardAffiliated withMedical Statistics Unit, London School of Hygiene and Tropical Medicine
  • , M. Salkinoja-SalonenAffiliated withDepartment of Applied Chemistry and Microbiology, University of Helsinki
  • , M. GisslerAffiliated withInformation Division, Social Welfare and Health Statistics Group, National Research and Development Centre for Welfare and Health
  • , M. KailaAffiliated withDepartment of General Practice, Pirkanmaa Hospital District and Paediatric Research Centre, University of Tampere
  • , A. ReunanenAffiliated withDepartment of Health and Functional Capacity, National Public Health Institute

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.

Keywords

Antimicrobial agents Child Pregnancy Registries Type 1 diabetes mellitus