Timing of Initial Cereal Exposure in Infancy and Risk of Islet Autoimmunity

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Abstract
Type 1 diabetes mellitus (DM) results from the destruction of the insulin-producing cells of the pancreas. Autoantibodies to the islet cells, or islet autoimmunity (IA), which mark this destructive process, can be present for years prior to the diagnosis of type 1 DM. Exposures in the infant diet have been implicated, albeit inconsistently, in the etiology of type 1 DM.1 Of 4 cohort studies examining IA as the outcome, 3 showed no effect of the duration of exclusive breastfeeding2,3 or age at exposure to cow's milk2,4 on the risk of IA, and 1 showed that short-term exclusive breastfeeding and early exposure to cow's milk increased risk for IA.5 One explanation for these discrepant findings is that exposure to cow's milk may be correlated with the actual diabetogenic exposure in some populations but not in others.