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EASD: Probiotic Use and Islet Autoimmunity in Young Children

Early probiotic supplementation may reduce the risk of islet autoimmunity in young children….

Gut microbiota play an important role in enhancing immune system and excluding pathogens competition. Previous studies have shown that dysbiosis in gut microbiota and impaired gut barrier could be associated with type 1 diabetes in humans and animals.

In a study presented at the 2014 European Association for the Study of Diabetes (EASD) Meeting, Dr. Ulla Uusitalo from the University of South Florida, Tampa and colleagues evaluated 8,502 children with type 1 diabetes from the Environmental Determinants of Diabetes in the Young (TEDDY) study to determine the association between early probiotic use and islet autoimmunity (IA).

IA was defined as the presence of one or more islet autoantibodies — GADA, IAA or IA-2A — confirmed in two consecutive visits. Probiotic introduction in the form of a supplement or infant formula containing probiotic was classified as: early introduction (at the age of <3 months), late introduction (at the age of ≥3 months) or no introduction (not introduced during the first 12 months).

Results of the study revealed that early introduction of probiotic was most common in Finland (35.9%), followed by Germany (24%), Sweden (11.6%) and the US (2.2%). In addition, early introduction of probiotic supplement was associated with reduced risk of IA, compare to late or no introduction (HR 0.62; 95%CI 0.45-0.84, P=0.0018).

The country-specific hazard risk ratios for associations between the early probiotic supplementation and IA were: Finland 0.72 (95%CI 0.49-1.07; P=0.10), Germany 0.65 (95%CI 0.26-2.55; P=0.37), Sweden 0.42 (95%CI 0.21-0.85; P=0.0165), and the US 0.62 (95%CI 0.15-2.50; P=0.5).

According to the researchers, data from this study suggested that “early probiotic supplementation may reduce risk of IA in children who are at elevated genetic risk of type 1 diabetes.” However, further studies are needed.

Practice Pearls:

  • Early probiotic supplementation may reduce risk of IA in children with high genetic risk of type 1 diabetes.
  • The data of this study showed that the association between IA and early probiotic use in children was significant in Sweden, but not in other countries.
  • Future studies should be conducted to further assess this association before any clinical recommendation is made.

Uusitalo U, Liu X, Yang J, et al. Probiotic use in infancy and islet autoimmunity in the environmental determinants of diabetes in the young (TEDDY) study. EASD Virtual Meeting. 18 Sep 2014. Web. 22 Sep 2014.