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Probiotics in newborns might lower diabetes risk

Use in first 27 days associated with 60% cut in risk of persistent islet autoimmunity

Louise Prime

Tuesday, 10 November 2015

Babies at increased genetic risk for type 1 diabetes (T1D) who are given probiotics in their first month after birth might have a 60% lower risk of developing islet autoimmunity than similar babies given probiotics later or not at all, according to the latest research. However, authors of the study,* published in JAMA Pediatrics, noted that the link might not be causal.

The Environmental Determinants of Diabetes in the Young (TEDDY) study started in 2004 with children from three clinical centres in the US and three in Europe (Finland, Germany and Sweden). Children had blood samples taken every three months between the ages of 3 and 48 months, and then every 6 months; they were tested for persistent islet autoimmunity. Their parents completed questionnaires and diaries with detailed information on infant feeding, including the use of probiotic supplementation and fortified formula.

Researchers analysed the results from the final study sample of 7,473 children aged 4-10 years. They found that Finland and Germany had the greatest prevalence of probiotic supplementation during a baby’s first year of life, from dietary supplements or fortified infant formula.

Among children with the highest-risk HLA genotype DR3/4, those with early probiotic exposure – i.e. who had had probiotics from either or both sources in the first 27 days following birth – had a 60% lower risk of persistent islet immunity compared with children whose first exposure to probiotics was later than that, and those who had never had them. In children not in this high-risk group, there was no association between early probiotic exposure and a reduced risk of islet autoimmunity.

The authors pointed out that the association is not necessarily causal, and they suggested further research into this. They concluded: “Early exposure to supplemental probiotics may decrease the risk of IA [islet autoimmunity] among children at elevated risk of T1DM. ... These results have to be confirmed before making recommendations on the use of probiotic supplementation.”

The author of a linked editorial** commented: “This protective association between early probiotic use and T1DM-related IA awaits further randomised clinical trials. ... While probiotic use in children is not that common in the United States, statistics in the current study show it to be more widespread in the study’s other participating sites of Finland, Germany and Sweden. This is an area in its infancy but likely to have a large impact on the medicine of the future.”

* Uusitalo U, Liu X, Yang J et al. Association of early exposure of probiotics and islet autoimmunity in the TEDDY study. JAMA Pediatr. Published online November 09, 2015. doi:10.1001/jamapediatrics.2015.2757

** Weinstock GM. A glimpse of microbial power in preventive medicine. JAMA Pediatr. Published online November 9, 2015. doi:10.1001/jamapediatrics.2015.3246.

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