Dr. Marla: Probiotics and an impact on diabetes in infants
A new study published this week looks at the use of probiotics during the first 27 days of an infant's life and whether this very early exposure could influence the risk of diabetes.
What exactly is a probiotic? Essentially these are live organisms that are often used for gut health and are usually advertised in yogurts.
Islet cells are found in the pancreas and in diabetes you can see islet autoimmunity among children who are at an increased genetic risk for type-1 diabetes. Islet autoimmunity occurs when antibodies attack islet cells in the pancreas that produce insulin.
Previous studies in animals have looked at changing gut bacteria by probiotics and the risk of developing type-1 diabetes (T1DM) related to autoimmunity.
The Environmental Determinants of Diabetes in the Young (TEDDY) study, started in 2004 with children from six clinical centers, three in the United States (Colorado, Georgia/Florida and Washington) and three in Europe (Finland, Germany and Sweden).
The children were followed-up for T1DM-related autoantibodies - antibodies against their own islet cells - with blood samples drawn every three months between 3 and 48 months of age and every six months thereafter to determine persistent islet autoimmunity. Questionnaires and diaries were used to detail infant feeding, including probiotic supplementation and infant formula use.
A final study sample consisted of 7,473 children who ranged in age from 4 to 10 years old.
Probiotic supplementation from dietary supplements or infant formula varied by country and was most common in Finland and Germany during the first year of a child's life.
Receiving probiotics through a dietary supplement or fortified infant formula, or both, by 27 days of age may be associated with a reduced risk of islet autoimmunity compared with those children who first received probiotics after 27 days of age or not at all.
Early probiotic exposure appeared to be associated with a 60 per cent decrease in the risk of islet autoimmunity among children with the highest-risk HLA genotype known to be associated with diabetes.
Probiotic use in children is not that common in North America but is more widespread in the study's other participating sites of Finland, Germany and Sweden. This is an area in its infancy but likely to have a large impact on the medicine of the future.