Rapid Early Growth
Linked to Type 1 Diabetes
Excerpt By Dana Frisch, Reuter's Health

NEW YORK (Reuters Health) - Babies and toddlers who grow relatively quickly may have a higher risk of developing type 1 diabetes before adolescence, according to a new report.

But the role a child's diet and duration of breast-feeding might have in this link remains unclear, the authors say.

In type 1 diabetes, the immune system mistakenly attacks and destroys the body's own insulin-producing cells, meaning patients must take daily injections of a synthetic version of the hormone for life.

The Centers for Disease Control and Prevention estimates that one out of every 400-500 children has type 1 diabetes, accounting for 5-10% of all diagnosed cases of diabetes.

Past research has linked fast early growth to the development of type 1 diabetes, but the role infant feeding might play has been unclear. To investigate, Dr. Chris Patterson and his colleagues recruited almost 500 diabetic children from Vienna, Latvia, Lithuania, Luxembourg and the UK and compared their height, weight and diet with over 1,300 children who were not diabetic.

Patterson told Reuters Health that looking at five European centers meant they could better generalize their results, which are reported in the October issue of the journal Diabetes Care.

"A positive finding observed across a number of countries can be an advantage as it offers some reassurance that the finding is not attributable to an unusual set of circumstances existing in one country," said Patterson, a reader in medical statistics at Queen's University in Belfast, Northern Ireland.

It is "difficult," Patterson said, to apply these results to other countries with large black or Hispanic populations, since the population in the five European countries studied was mainly Caucasian.

Patterson and his team found that the children with diabetes had indeed grown more quickly during childhood than children without diabetes, and that increased weight was more strongly associated with diabetes than height. When growth was measured by body mass index, a measure of weight in relation to height, diabetic children were again found to have grown more rapidly than non-diabetic kids.

Researchers found that breast-feeding decreased the risk of developing the disease, and that switching an infant to a diet of solid foods, formula or cows milk before three months of age did not increase the risk. But the reasons for these feeding effects, or lack thereof, remain unclear, they say.

Patterson cautions that parents might not accurately recall when a child stopped breast-feeding, for example, since the study was retrospective, and some of the children were 15 years old.

Parents should not make any changes in their children's diet based on these results, said Patterson, and the results of this observational study should not be "over-interpreted."

"We cannot say that restricting children's weight gain in early childhood will actually reduce their risk of type 1 diabetes," said Patterson.

The study provides another "piece in the jigsaw for those who are engaged in the difficult task of determining the patho-physiological processes that eventually result in childhood diabetes," Patterson said.

SOURCE: Diabetes Care 2002;25:1755-1760.

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