Saturday, October 8, 2011

Antibiotics and Type-1 Diabetes

I occasionally get asked about a link between antibiotics and type-1 diabetes.  Basically, people want to know if our expanding use of antibiotics is causing cases of type-1 diabetes.

The following study looked at this issue specifically (use of antibiotics causing type-1 diabetes) and found that it did not happen:

Denmark has a centralized records medical system, so it is possible to do studies where you look at all children in the country, and compare their antibiotics usage to their type-1 diabetes status.  We could never do something like that here in the USA, but we can benefit from the studies done in other countries.  This study was based on about 600,000 patients, and was just published recently (in 2009).

Here is about half of their abstract.  I've removed the numbers, so that it reads better:
Use of any antibiotic was not associated with type 1 diabetes. Evaluation of type 1 diabetes risk according to number of courses of any antibiotic yielded no association between antibiotic use and type 1 diabetes. No specific class of antibiotics was associated with type 1 diabetes, no specific age of use was associated with type 1 diabetes, and no specific age at onset of type 1 diabetes was associated with antibiotics. In a large nationwide prospective study, no association between antibiotic use and type 1 diabetes was found among Danish children.
I have not found any controlled clinical (human) studies which show that increased antibiotic use increases the chance of type-1 diabetes.

Joshua Levy
All the views expressed here are those of Joshua Levy, and nothing here is official JDRF or JDCA news, views, policies or opinions.


Kristin said...

Thanks for posting - interesting to read this. And it is amazing the data that's tracked in Scandinavian countries - makes our CDC look pretty primitive.

Joshua Levy said...

Actually, I don't think it is our CDC that is primitive, but rather our health care payment system. The records that are used in Scandinavian countries to do this kind of research all come from their "single payer" health system. Because -- at the end of the day -- payments are handled through one system, you can query that system to find out if a kid got antibiotics and if that same kid was diagnosed with type-1 diabetes. So they can do large scale studies like that on the whole population.

David said...

We can do something similar to this in the US. Big health "care" firms such as Kaiser have huge databases, sometimes for long periods of patients' lives. These data can be mined, and it's done. Catch is that it's not really "free" data ...

Joshua Levy said...

It can be mined, but it is not the same. For one thing, it only covers people with health insurance. So in the USA, that kind of study would be biased in terms of only covering the employed and relatively well employed. Also, there is a time problem. Even people with insurance often change that insurance every few years. So in this case, the kid might have been given antibiotics by one insurance company, but treated for type-1 by another. So you could not have done the study. (You would have had to limit the study to people who had one insurance company for over a decade: a very rare breed, indeed!