Sociodemographic determinants of early weaning: a Finnish birth cohort study in infants with human leucocyte antigen-conferred susceptibility to type 1 diabetes

AbstractObjectiveTo assess the most important sociodemographic determinants of age at introduction of complementary foods in infancy.DesignA prospective birth cohort with increased risk of type 1 diabetes, recruited between 1996 and 2004. The families completed at home a follow-up form on the age at introduction of new foods and, for each clinic visit, a structured dietary questionnaire with 3 d food records.SettingData from the Type 1 Diabetes Prediction and Prevention (DIPP) Project, Finland.SubjectsA cohort of 5991 infants (77 % of those invited) belonging to the DIPP Nutrition Study.ResultsSixty-three per cent of the infants were introduced to complementary foods, including infant formula, before the age of 4 months. The median age at introduction of infant formula was 1·5 months (range 0–18 months) and that of the first other complementary food 3·5 months (range 0·7–8 months). All sociodemographic and lifestyle factors studied were associated with the age at introduction of infant formula and/or first other complementary food. Female sex of the infant, being born in the southern region of Finland, living in a rural municipality, the presence of siblings, the mother or the father being a high-school graduate, high maternal professional education and maternal non-smoking during pregnancy predicted later introduction of complementary foods.ConclusionsCompliance was relatively poor with the current recommendations for the age of introducing complementary foods. Small-sized young families with less well-educated parents were most prone to introduce complementary foods early.

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Maternal dietary fatty acid intake during pregnancy and the risk of preclinical and clinical type 1 diabetes in the offspring

British Journal Of Nutrition ◽

10.1017/s0007114513003073 ◽

2013 ◽

Vol 111 (5) ◽

pp. 895-903 ◽

Cited By ~ 10

Author(s):

Sari Niinistö ◽

Hanna-Mari Takkinen ◽

Liisa Uusitalo ◽

Jenna Rautanen ◽

Jaakko Nevalainen ◽

...

Keyword(s):

Type 1 Diabetes ◽

Fatty Acid ◽

Cox Proportional Hazards ◽

Fatty Acid Intake ◽

Acid Intake ◽

Sour Milk ◽

Clinical Type ◽

Prediction And Prevention ◽

Increased Risk

The aim of the present study was to examine the associations between the maternal intake of fatty acids during pregnancy and the risk of preclinical and clinical type 1 diabetes in the offspring. The study included 4887 children with human leucocyte antigen (HLA)-conferred type 1 diabetes susceptibility born during the years 1997–2004 from the Finnish Type 1 Diabetes Prediction and Prevention Study. Maternal diet was assessed with a validated FFQ. The offspring were observed at 3- to 12-month intervals for the appearance of type 1 diabetes-associated autoantibodies and development of clinical type 1 diabetes (average follow-up period: 4·6 years (range 0·5–11·5 years)). Altogether, 240 children developed preclinical type 1 diabetes and 112 children developed clinical type 1 diabetes. Piecewise linear log-hazard survival model and Cox proportional-hazards regression were used for statistical analyses. The maternal intake of palmitic acid (hazard ratio (HR) 0·82, 95 % CI 0·67, 0·99) and high consumption of cheese during pregnancy (highest quarter v. intermediate half HR 0·52, 95 % CI 0·31, 0·87) were associated with a decreased risk of clinical type 1 diabetes. The consumption of sour milk products (HR 1·14, 95 % CI 1·02, 1·28), intake of protein from sour milk (HR 1·15, 95 % CI 1·02, 1·29) and intake of fat from fresh milk (HR 1·43, 95 % CI 1·04, 1·96) were associated with an increased risk of preclinical type 1 diabetes, and the intake of low-fat margarines (HR 0·67, 95 % CI 0·49, 0·92) was associated with a decreased risk. No conclusive associations between maternal fatty acid intake or food consumption during pregnancy and the development of type 1 diabetes in the offspring were detected.

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Determinants of breast-feeding in a Finnish birth cohort

Public Health Nutrition ◽

10.1017/s1368980009991777 ◽

2009 ◽

Vol 13 (4) ◽

pp. 504-513 ◽

Cited By ~ 36

Author(s):

Maijaliisa Erkkola ◽

Maija Salmenhaara ◽

Carina Kronberg-Kippilä ◽

Suvi Ahonen ◽

Tuula Arkkola ◽

...

Keyword(s):

Type 1 Diabetes ◽

Breast Milk ◽

Birth Cohort ◽

Infant Feeding ◽

Breast Feeding ◽

Validation Study ◽

Maternity Ward ◽

Sociodemographic Determinants ◽

Milk Feeding

AbstractObjectiveTo assess milk feeding on the maternity ward and during infancy, and their relationship to sociodemographic determinants. The validity of our 3-month questionnaire in measuring hospital feeding was assessed.DesignA prospective Finnish birth cohort with increased risk to type 1 diabetes recruited between 1996 and 2004. The families completed a follow-up form on the age at introduction of new foods and age-specific dietary questionnaires.SettingType 1 Diabetes Prediction and Prevention (DIPP) project, Finland.SubjectsA cohort of 5993 children (77 % of those invited) participated in the main study, and 117 randomly selected infants in the validation study.ResultsBreast milk was the predominant milk on the maternity ward given to 99 % of the infants. Altogether, 80 % of the women recalled their child being fed supplementary milk (donated breast milk or infant formula) on the maternity ward. The median duration of exclusive breast-feeding was 1·4 months (range 0–8) and that of total breast-feeding 7·0 months (0–25). Additional milk feeding on the maternity ward, short parental education, maternal smoking during pregnancy, small gestational age and having no siblings were associated with a risk of short duration of both exclusive and total breast-feeding. In the validation study, 78 % of the milk types given on the maternity ward fell into the same category, according to the questionnaire and hospital records.ConclusionsThe recommendations for infant feeding were not achieved. Infant feeding is strongly influenced by sociodemographic determinants and feeding practices on the maternity wards. Long-term breast-feeding may be supported by active promotion on the maternity ward.

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Maternal Vitamin C and Iron Intake during Pregnancy and the Risk of Islet Autoimmunity and Type 1 Diabetes in Children: A Birth Cohort Study

Nutrients ◽

10.3390/nu13030928 ◽

2021 ◽

Vol 13 (3) ◽

pp. 928

Author(s):

Markus Mattila ◽

Leena Hakola ◽

Sari Niinistö ◽

Heli Tapanainen ◽

Hanna-Mari Takkinen ◽

...

Keyword(s):

Type 1 Diabetes ◽

Vitamin C ◽

Birth Cohort ◽

Islet Autoimmunity ◽

Birth Cohort Study ◽

Iron Intake ◽

Family History Of Diabetes ◽

Maternal Vitamin ◽

Prediction And Prevention

Our aim was to study the associations between maternal vitamin C and iron intake during pregnancy and the offspring’s risk of developing islet autoimmunity and type 1 diabetes. The study was a part of the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) prospective birth cohort including children genetically at risk of type 1 diabetes born between 1997–2004. The diets of 4879 mothers in late pregnancy were assessed with a validated food frequency questionnaire. The outcomes were islet autoimmunity and type 1 diabetes. Cox proportional hazards regression analysis adjusted for energy, family history of diabetes, human leukocyte antigen (HLA) genotype and sex was used for statistical analyses. Total intake of vitamin C or iron from food and supplements was not associated with the risk of islet autoimmunity (vitamin C: HR 0.91: 95% CI (0.80, 1.03), iron: 0.98 (0.87, 1.10)) or type 1 diabetes (vitamin C: 1.01 (0.87, 1.17), iron: 0.92 (0.78, 1.08)), neither was the use of vitamin C or iron supplements associated with the outcomes. In conclusion, no association was found between maternal vitamin C or iron intake during pregnancy and the risk of islet autoimmunity or type 1 diabetes in the offspring.

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Autoantibodies to N-Terminally Truncated GAD65(96–585): HLA Associations and Predictive Value for Type 1 Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab816 ◽

2021 ◽

Author(s):

Petra M Pöllänen ◽

Taina Härkönen ◽

Jorma Ilonen ◽

Jorma Toppari ◽

Riitta Veijola ◽

...

Keyword(s):

Type 1 Diabetes ◽

Predictive Value ◽

Dietary Intervention ◽

Venous Blood ◽

Islet Cell Antibodies ◽

Acid Decarboxylase ◽

Prediction And Prevention ◽

Increased Risk ◽

Combining Data

Abstract Objective To evaluate the role of autoantibodies to N-terminally truncated glutamic acid decarboxylase GAD65(96–585) (t-GADA) as a marker for type 1 diabetes (T1D) and to assess the potential HLA-associations with such autoantibodies. Design In this cross-sectional study combining data from the Finnish Pediatric Diabetes Register, the Type 1 Diabetes Prediction and Prevention (DIPP) Study, the DIABIMMUNE Study, and the Early Dietary Intervention and Later Signs of Beta-Cell Autoimmunity (EDIA) Study, venous blood samples from 760 individuals (53.7% males) were analyzed for t-GADA, autoantibodies to full-length GAD65 (f-GADA), and islet cell antibodies. Epitope-specific GAD autoantibodies were analyzed from 189 study participants. Results T1D had been diagnosed in 174 (23%) participants. Altogether 631 (83%) individuals tested positive for f-GADA and 451 (59%) for t-GADA at a median age of 9.0 years (range 0.2–61.5). t-GADA demonstrated higher specificity (46%) and positive predictive value (30%) for T1D than positivity for f-GADA alone (15% and 21%, respectively). Among participants positive for f-GADA, those who tested positive for t-GADA carried more frequently HLA genotypes conferring increased risk for T1D than those who tested negative for t-GADA (77 vs. 53%; P<0.001). Conclusions Autoantibodies to N-terminally truncated GAD improve the screening for T1D compared to f-GADA and may facilitate the selection of participants for clinical trials. HLA class II-mediated antigen presentation of GAD(96–585)-derived or structurally similar peptides might comprise an important pathomechanism in T1D.

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Immune status is associated with the mode of delivery in infants at increased risk for Type 1 Diabetes

Diabetologie und Stoffwechsel ◽

10.1055/s-0034-1374887 ◽

2014 ◽

Vol 9 (S 01) ◽

Author(s):

O D'Orlando ◽

R Puff ◽

A Henniger ◽

S Krause ◽

F Haupt ◽

...

Keyword(s):

Type 1 Diabetes ◽

Immune Status ◽

Mode Of Delivery ◽

Increased Risk

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Metabolic Markers Associated with Increased Risk for Progression from Single to Multiple Autoantibodies in Type 1 Diabetes Relatives

Diabetes ◽

10.2337/db18-94-or ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 94-OR

Author(s):

EMANUELE BOSI ◽

SUSAN GEYER ◽

JAY SOSENKO ◽

DOROTHY J. BECKER ◽

MANUELA BATTAGLIA ◽

...

Keyword(s):

Type 1 Diabetes ◽

Metabolic Markers ◽

Increased Risk

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836-P: Cannabis Use in Adults with Type 1 Diabetes (T1D) Is Associated with Poor Glycemic Control and Increased Risk for Diabetic Ketoacidosis (DKA)

Diabetes ◽

10.2337/db19-836-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 836-P ◽

Cited By ~ 1

Author(s):

VIRAL N. SHAH ◽

DANIEL D. TAYLOR ◽

NICOLE C. FOSTER ◽

ROY BECK ◽

HALIS K. AKTURK ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Diabetic Ketoacidosis ◽

Cannabis Use ◽

Poor Glycemic Control ◽

Increased Risk

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New Advanced Technology to Improve Prediction and Prevention of Type 1 Diabetes

10.21236/ada469956 ◽

2005 ◽

Author(s):

Robert A. Vigersky

Keyword(s):

Type 1 Diabetes ◽

Advanced Technology ◽

Prediction And Prevention

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Coeliac disease is associated with depression in children and young adults with type 1 diabetes: results from a multicentre diabetes registry

Acta Diabetologica ◽

10.1007/s00592-020-01649-8 ◽

2021 ◽

Author(s):

Sascha René Tittel ◽

◽

Désirée Dunstheimer ◽

Dörte Hilgard ◽

Burkhild Knauth ◽

...

Keyword(s):

Type 1 Diabetes ◽

Young Adults ◽

Coeliac Disease ◽

Diabetes Patient ◽

Routine Care ◽

Diabetes Registry ◽

Increased Risk ◽

Treatment Data ◽

Children And Young Adults

Abstract Aims To analyse the association between coeliac disease (CD) and depression in children, adolescents, and young adults with type 1 diabetes (T1D). Methods We included 79,067 T1D patients aged 6–20 years, with at least six months of diabetes duration, and treatment data between 1995 and 2019 were documented in the diabetes patient follow-up registry. We categorized patients into four groups: T1D only (n = 73,699), T1 + CD (n = 3379), T1D + depression (n = 1877), or T1D + CD + depression (n = 112). Results CD and depression were significantly associated (adjusted OR: 1.25 [1.03–1.53]). Females were more frequent in both the depression and the CD group compared with the T1D only group. Insulin pumps were used more frequently in T1D + CD and T1D + depression compared with T1D only (both p < .001). HbA1c was higher in T1D + depression (9.0% [8.9–9.0]), T1D + CD + depression (8.9% [8.6–9.2]), both compared with T1D only (8.2% [8.2–8.2], all p < .001). We found comorbid autism, attention deficit hyperactivity disorder, anxiety, schizophrenia, and eating disorders more frequently in the T1D + CD + depression group compared with T1D only (all p < .001). Conclusions CD and depression are associated in young T1D patients. The double load of T1D and CD may lead to an increased risk for depression. Depression was associated with additional psychological and neurological comorbidities. Aside from imperative CD screening after T1D diagnosis and regular intervals, depression screening might be helpful in routine care, especially in patients with diagnosed CD.

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