The Belgrade childhood diabetes study: a multivariate analysis of risk determinants for diabetes

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Abstract
Background: The aim of this study was to evaluate some hypotheses about factors related to the development of type 1 diabetes mellitus. Methods: A case–control study was conducted in Belgrade during the period 1994–1997. A total of 105 recently onset diabetic and 210 control children, individually matched by age (±1 year), sex and place of residence, were included in the study. Results: According to multivariate regression analysis, the following factors were related to type 1 diabetes: stressful events and symptoms of psychological dysfunction during the 12 months preceding the onset of the disease [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.15–5.65; and OR 2.15, 95% CI 1.33–3.48], irregular vaccination (OR 16.98, 95% CI 1.38–208.92), infection during 6 months preceding the onset of the disease (OR 4.23, 95% CI 1.95–9.17), higher education of father (OR 1.50, 95% CI 1.05–2.14), mother's consumption of nitrosoamines-rich food during pregnancy (OR 4.33, 95% CI 1.95–9.61), alcohol consumption by father (OR 3.80, 95% CI 1.64–8.78), insulin-dependent and non-insulin-dependent diabetes mellitus in three generations of children's relatives (OR 20.04, 95% CI 4.73–84.81; and OR 5.52, 95% CI 2.45–12.46), and use of ultrasound diagnostic techniques during pregnancy (OR 0.42, 95% CI 0.17–1.00). Conclusions: Among non-genetic factors, those affecting the child during pregnancy are especially important because of their preventability.