Does modern high standard life style cause type 1 diabetes in children?

Type 1 diabetes is a serious disease which, in spite of intensive treatment, causes serious complications and increased mortality. The incidence is increasing, but the aetiology is unknown. As part of modern lifestyle, increased hygiene has been suspected as one contributing cause but so far there is no evidence. Several large epidemiological studies, mainly restricted to children with increased genetic risk for type 1 diabetes, have so far given no clue.

All Babies in Southeast Sweden is unique in its design as it has followed an unselected group of children from birth 1997-1999 and onwards with regular follow-ups. This report is based on questionnaires from initially 16 051 children of whom 80 have later on developed type 1 diabetes. The parents answered questionnaires at the birth of their child and then after 1, 2-3, 5-6 and 8 years. A number of parameters possibly related to hygiene were analysed with several statistical methods, both with univariate and in regression models.

Our study cannot identify any crucial environmental factor. This indicates that hygiene-related parameters traditionally regarded as part of 'modern life style' do not play any important role for the aetiology of type 1 diabetes.

There is no reason to recommend a change of that part of our lifestyle. We find weak associations to previous gastrointestinal infections, which gives a hint that development of type 1 diabetes may be related to problems in the gut and maybe one should look closer into the microbes living in the gut.