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Does Delaying Gluten Exposure Lower the Rates of Islet Autoimmunity in Children with Type 1 Diabetes Risk?
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Celiac.com 06/08/2011 - A team of researchers recently set out to determine whether delaying gluten introduction in infants with genetic risk for islet autoimmunity is feasible, safe, and able to reduce the risk of type 1 diabetes–associated islet autoimmunity.
The research team included Sandra Hummel, PHD, Maren Pflüger, PHD, Michael Hummel, MD, Ezio Bonifacio, PHD, and Anette-G. Ziegler, MD.
They are variously affiliated with the Institute for Diabetes Research, Helmholtz Zentrum München, Forschergruppe Diabetes der Technischen Universität München, the Institut für Diabetesforschung der Forschergruppe Diabetes e.V. am Helmholtz Zentrum München, Munich, Germany, and the Deutsche Forschungsgemeinschaft Center for Regenerative Therapies Dresden, Technische Universität Dresden, Germany.
For the study, the team recruited a total of 150 infants with a first-degree family history of type 1 diabetes and a risk HLA genotype.
They then randomly assigned each infant to a first gluten exposure at age 6 months (control group) or 12 months (late-exposure group).
The team followed-up on each infant at three month-intervals until the age of 3 years, and then yearly thereafter. The team tested for growth and autoantibodies to transglutaminase C [TGCAs]), islet autoantibodies to insulin, GAD, insulinoma-associated protein 2, and type 1 diabetes.
A total of 70% of families reported following the dietary-intervention protocol. For the first three years, children in the control and late-exposure groups showed similar weight and height, along with similar probability of developing TGCAs (14 vs. 4%; P = 0.1).
A total of eleven children in the control group and 13 children in the late-exposure group developed islet autoantibodies (3-year risk: 12 vs. 13%; P = 0.6).
Seven children developed diabetes, including four in the late-exposure group. The team saw no significant differences when analyzing children as per protocol on the basis of the first reported reported gluten exposures for the children.
From the data, the team concluded that delaying gluten exposure until the age of 12 months is safe, but does not significantly reduce the likelihood of islet autoimmunity in genetically at-risk children.
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