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Archive for March, 2013

Is Type 1 diabetes linked to lower exposure to bacteria in early life?

23 Mar, 13 | by Dr Dean Jenkins

One of the posters at the Society for Endocrinology 2013 conference in Harrogate was from a team in Malta who claimed Type 1 diabetes is related to reduced exposure to bacteria in early life [1]. They pulled together three sources of data the WHO DiaMond Project (reported cases of Type 1 diabetes), the WHO estimates of mortality, and the Alexander Project [2] (antimicrobial susceptibility). The Society for Endocrinology also published a press release from the conference.

In their abstract the authors concluded:

“We found a negative correlation between country incidence of T1DM and its mortality from infectious diseases. Mortality from infectious diseases is a strong marker of the total infective burden. Incidence of T1DM was found to be positively correlated with the susceptibility of S. pneumoniae to all antibiotics studihttp://commons.wikimedia.org/wiki/File%3APseudomonas_aeruginosa_on_cetrimide_agar.jpged. Increased antibiotic susceptibility of a given organism may be an indirect marker of a low degree of exposure of the community to it. Our results provide support for the hygiene hypothesis, namely that diminished bacterial exposure in early post-natal life results in increased risk of developing T1DM.”

Whilst there is not a great deal that can be extrapolated from this abstract – which has the potential of compounding the errors of observation within the three different surveys – it is, perhaps, a signal worthy of further study. The hygiene hypothesis has a long history and seeks to explain the higher incidence of Type 1 diabetes where societies have lost their ‘old friends’ – co-evolutionary organisms – and their immune systems develop abnormal responses. [3]

 

1. Abela A-G, Fava S. Association of the incidence of type 1 diabetes with markers of infection and antibiotic susceptibility at country level. Presented at Society for Endocrinology BES 2013, Harrogate, UK. Endocrine Abstracts (2013) 31 P223 | DOI:10.1530/endoabs.31.P223. Available from: http://www.endocrine-abstracts.org/ea/0031/ea0031P223.htm

2. Felmingham D, White AR, Jacobs MR, Appelbaum PC, Poupard J, Miller LA, Grüneberg RN. The Alexander Project: the benefits from a decade of surveillance. J. Antimicrob. Chemother. 2005 Oct;56 Suppl 2:ii3–ii21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16282278

3. Gale, E.A.M. Hygiene hypothesis [internet]. 2012 [cited 2013 Mar 23]; Diapedia 21040851207 rev. no. 30. Available from: http://www.diapedia.org/type-1-diabetes-mellitus/21040851207/hygiene-hypothesis

Filtering the diabetes noise

20 Mar, 13 | by Dr Dean Jenkins

I’ve always been interested in how to keep up to date. Staying abreast of developments in a specialty is an important aspect of the role of a physician. You can share this knowledge with others. I came across these three papers today and I’ll explain how in a moment.

“Soft drink consumption is significantly linked to overweight, obesity, and diabetes worldwide, including in low- and middle-income countries.”

Basu S, McKee M, Galea G, Stuckler D. Relationship of Soft Drink Consumption to Global Overweight, Obesity, and Diabetes: A Cross-National Analysis of 75 Countries. Am J Public Health 2013 Mar;

“Low self-rated health was associated with a higher risk of type 2 diabetes. The association could be only partly explained by other health-related variables, of which obesity was the strongest.”

Wennberg P, Rolandsson O, Van der A DL, Spijkerman AMW, Kaaks R, Boeing H, Feller S, Bergmann MM, Langenberg C, Sharp SJ, Forouhi N, Riboli E, Wareham N. Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study. BMJ Open 2013;3(3)

“long-term BPA exposure [a compound in plastic bottles] at a dose three times higher than the tolerable daily intake of 50 µg/kg, appeared to accelerate spontaneous insulitis and diabetes development in NOD mice.”

Bodin J, Bølling AK, Samuelsen M, Becher R, Løvik M, Nygaard UC. Long-term bisphenol A exposure accelerates insulitis development in diabetes-prone NOD mice. Immunopharmacol Immunotoxicol 2013 Mar;

If I were presented with these papers as someone with a keen interest in the clinical care of diabetes then I think I’d find them rather interesting. Apart from the plastic bottles and NOD mice – which I know less about – the papers would seem to shape my understanding of the causes of diabetes. The first paper would raise my awareness of the importance of soft drinks (which has been in the news recently as well so patients might visit with questions). The second would highlight the psychological factors behind the risks for Type 2 Diabetes and obesity.

So, where did they come from?

From the library? No.

From a news agency on a website or email spam? No.

A PubMed search and crawl? No.

From my mates on Twitter? Not exactly.

From collecting all 40,000 tweets in the past 48 hours mentioning ‘diabetes’ and analysing them using various algorithms. Well yes.

Is this another way of filtering the diabetes noise? By tapping into the collaborative work of others. I think we’ll see more of it … perhaps, in the 21st Century, we already do.

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