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. 2022 Jun;77(1):48-56.
doi: 10.1007/s12020-022-03057-0.

Prenatal and early life factors and type 1 diabetes

Alexia G Abela  1 , Stephen Fava  2
Affiliations

Prenatal and early life factors and type 1 diabetes

Alexia G Abela et al. Endocrine. 2022 Jun.

Abstract

Background: The prevalence of type 1 diabetes is increasing worldwide, suggesting that unknown environmental factors are becoming increasingly important in its pathogenesis.

Aim: The aim of the study was to investigate the possible role of a number of prenatal and perinatal factors in the aetiology of type 1 diabetes.

Methods: Mothers of patients diagnosed with type 1 diabetes (cases) and mothers of children born on the same day and of the same sex as type 1 diabetes patients (controls) were interviewed on a number of prenatal and perinatal factors of interest.

Results: Hand washing prior to eating, frequency of bathing and total stress score were found to be positively associated with the development of type 1 diabetes on univariate analyses. Hand-washing prior to eating and frequency of house cleaning were independently associated with an increased risk of type 1 diabetes, whilst getting dirty was associated with a reduced risk in multivariate analyses. There was no association of type 1 diabetes to removing of outdoor shoes indoors or to the age of first attendance to school or pre-school. There were also no significant associations to parental smoking, parental age, birth order, infant feeding, antibiotic use, mode of delivery or birth weight.

Conclusion: Our data suggest that factors that affect the skin or gut microbiome might be more important than infections or factors affecting the microbiome at other sites.

Keywords: Environmental factors; Hygiene hypothesis; Microbiome; Psychological stress; Type 1 diabetes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Frequency of hand washing prior to eating for type 1 diabetes patients and controls. ‘p’ value refers to the statistical significance of the difference in the frequency distribution between subjects with type 1 diabetes and controls as assessed by the χ2 test
Fig. 2
Fig. 2
Frequency of bathing for type 1 diabetes patients and controls. ‘p’ value refers to the statistical significance of the difference in the frequency distribution between subjects with type 1 diabetes and controls as assessed by the χ2 test
Fig. 3
Fig. 3
Number of life events in the Holmes and Rahe Non-Adult Stress Scale for type 1 diabetes patients and controls until the age at diagnosis of type 1 diabetes. ‘p’ value refers to the statistical significance between subjects with type 1 diabetes and controls as assessed by the χ2 test
Fig. 4
Fig. 4
Total stress score in life change units on the Holmes and Rahe Non-Adult Stress Scale for type 1 diabetes patients and controls until the age at diagnosis of type 1 diabetes. ‘p’ value refers to the statistical significance between subjects with type 1 diabetes and controls as assessed by the χ2 test
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