INFEKTIOTAUDIT DIABETEKSEN AIHEUTTAJINA

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Lähettäjä: Soijuv Lähetetty: 31.7.2006 16:47

Infections linked to Type 1 diabetes
04 July 2006
Diabetologia 2006: 49: 900­904
Results of a UK study have provided further evidence to suggest that common
infections may trigger the development of Type 1 diabetes in children and
young adults.

Type 1 diabetes is a form of the condition in which the body is unable to
produce any insulin. The disorder usually develops before the age of 40
years and is associated with an increased risk of high blood pressure, heart
disease and other cardiovascular problems.

Lead researcher Dr Richard McNally, from the University of Newcastle, and
his team say that previous studies have suggested that infections are linked
to the development of Type 1 diabetes in children who are genetically
susceptible to certain environmental triggers.

To investigate further, the researchers used sophisticated analytical
techniques to study data on more than 4000 Type 1 diabetes sufferers who
were aged between 0 and 29 years.

Results of the analysis revealed that there were "clusters" of new diabetes
cases in certain places and at certain times among adolescents aged between
10 and 19 years. Indeed, there were up to 7% more cases of Type 1 diabetes
in these "clusters" than would normally have been expected.

The researchers say that this pattern of clustering is typical of conditions
that are triggered by by infections.

Commenting on the findings, Dr NcNally said: "This research brings us closer
to understanding more about Type 1 diabetes. However, it's just one piece in
the jigsaw and much more research is needed before we can identify which
infections may be to blame and thus inform advice on preventative measures.

"The condition is likely to be caused by an interplay of factors, of which
infections are just one element."

Simon O'Neill, from the charity Diabetes UK, added: "We always suspected
that common infections could be a trigger for Type 1 diabetes in those who
are already genetically susceptible. This research provides vital evidence
in supporting this link.

"The fact that the number of cases of Type 1 diabetes is rising by 3% each
year cannot be explained by genetics alone. This research reinforces the
idea that common infections and environmental factors also play a part."

The study is published in the journal Diabetologia.
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Diabetologia
Publisher: Springer Berlin / Heidelberg
ISSN: 0012-186X (Paper) 1432-0428 (Online)
DOI: 10.1007/s00125-006-0208-5
Issue: Volume 49, Number 5
Date: May 2006
Pages: 900 - 904
Short Communication

Space­time clustering analyses of type 1 diabetes among 0- to 29-year-olds
in Yorkshire, UK
R. J. Q. McNally1, 2, 6 , R. G. Feltbower3, L. Parker1, H. J. Bodansky4, F.
Campbell5 and P. A. McKinney3

(1) School of Clinical Medical Sciences (Child Health), University of
Newcastle upon Tyne, Newcastle upon Tyne, UK
(2) School of Population and Health Sciences, University of Newcastle
upon Tyne, Newcastle upon Tyne, UK
(3) Paediatric Epidemiology Group, Centre for Epidemiology and
Biostatistics, University of Leeds, Leeds, UK
(4) The General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust,
Leeds, UK
(5) St James¹s University Hospital, Leeds Teaching Hospitals NHS Trust,
Leeds, UK
(6) Sir James Spence Institute, Level 4, Royal Victoria Infirmary, Queen
Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
Received: 16 August 2005 Accepted: 3 January 2006 Published online: 24
March 2006

Abstract
Aims/hypothesis Infections have been suggested to play a role in the
aetiology of type 1 diabetes. The presence of space­time clustering is
consistent with the notion of an environmental component in disease
aetiology, possibly linked to infections. We tested for evidence of
space­time clustering among children and young adults under 30 years of age
using data from a population-based register in Yorkshire, UK.
Subjects and methods Two data sets of children and young people diagnosed
with type 1 diabetes were analysed: (1) children aged 0­14 years and
resident in Yorkshire during 1978­2002; (2) those aged 15­29 years and
resident in West Yorkshire during 1991­2002. Tests for space­time
interactions between cases were applied. Addresses at diagnosis were
geo-coded and used as the basis for the analyses.
Results The study analysed 3,019 type 1 diabetic patients in the 0­14 years
age group and 989 patients in the 15­29 years group. Statistically
significant space­time clustering based on place and time of diagnosis was
detected both for the 10­14-year-olds (p=0.04) and for the 15­19-year-olds
(p=0.01).
Conclusions/interpretation Previous studies of clustering of type 1
diabetes have generally been restricted to childhood. Our results from a
data set that includes teenagers and young adults show that space­time
clustering was limited to young people aged 10­19 years. This finding is
consistent with an aetiology involving late exposure to infection. However,
the question of whether this is directly diabetogenic or unmasks latent
diabetes cannot be addressed by this methodology.
Keywords Aetiology - Children - Diabetes - Infection - Space­time
clustering


R. J. Q. McNally
Email: Richard.McNally@ncl.ac.uk
Phone: +44-191-2023029
Fax: +44-191-202