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Decreased prevalence of atopic diseases in children with diabetes. The EURODIAB Substudy 2 Study Group.

OBJECTIVE
To test the hypothesis that atopic diseases in early life are associated with a reduced risk (protection) for the development of type 1 diabetes in childhood.


STUDY DESIGN
European centers (n = 8) with access to population-based type 1 diabetes registries (>90% degree of ascertainment) participated in a case control study focusing on early exposures and risk factors for type 1 diabetes. Altogether, data from 1028 members of a case group and 2744 members of a control group corresponding to 85.4% eligible members of the case group and 76.1% of the control group were analyzed. Information in this study was collected regarding atopic diseases (atopic eczema, allergic rhinoconjunctivitis, and asthma).


RESULTS
Atopic disease and asthma particularly are associated with significant reductions in risk of childhood type 1 diabetes. The risk reduction associated with asthma was observed reasonably consistently among the 8 study centers, which represent a wide range of diabetes incidence. Risk reductions associated with all 3 expressions of atopy were particularly marked in children whose type 1 diabetes was diagnosed in the 10- to 14-year age group.


CONCLUSION
These findings indicate that atopic conditions may be protective against the development of type 1 diabetes and are consistent with the immunologic concept of T(H)1 (type 1 diabetes) and T(H)2 (atopy) diseases being mutually exclusive.