Non‐genetic risk determinants for type 1 (insulin‐dependent) diabetes mellitus in childhood

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Abstract
Using the prospective Hungarian childhood diabetes register, a nationwide case‐control study was carried out to investigate the possible role of various non‐genetic factors as risk determinants for type 1 diabetes in childhood. A questionnaire (covering family characteristics, social status, fetal and perinatal events, breast‐feeding habits, infectious diseases and stressful life events) was sent by mail to all incident diabetic children in 1990 (n= 163) and to two referent children (for each diabetic chdd), matched for age, sex and county. Diabetic children had a tendency to have mothers > 35 years of age (odds ratio (OR) = 3.52; 95% confidence intervals (CI) 0.74–16.79), a lower proportion of their mothers had higher education (OR = 1.69; 95% CI 0.95–3.0) and these children tended to move home more frequently (OR = 1.99; 95% CI 0.97–4.1). Although the duration of exclusive breast feeding was similar in both groups, the proportion of diabetic children who received no breast milk tended to be higher (OR= 1.76; 95% CI 0.91–3.4). A higher proportion of diabetic children reported non‐specific infections (OR = 2.94; 95% CI 1.19–7.21) and the number of stressful life events was higher in diabetic children aged 10–14 years (OR = 3.9; 95% CI 1.14–13.27). As the risk determinants for childhood insulin‐dependent diabetes mellitus identified in our low‐risk population appear to be similar to those detected in the genetically different, high‐risk Swedish population, our study strongly supports an etiological role for these non‐genetic risk factors in IDDM.