Recurrent Respiratory Infections in Early Childhood Could Double Odds of Diabetes Onset

Children who experience recurrent viral respiratory infections by age 2 face a more than 2-fold risk for type 1 diabetes (T1D) by age 5, recent study results suggest.

The study, which was published in a recentJAMAresearch letter, sought to determine the relationship between recurrent respiratory infections in the first 6 months of life and T1D onset. This relationship had previously been observed, but past studies never included a cohort representative of the general population.

Using insurance claims data from 295,420 infants in Germany, the researchers tracked the incidence and cause of respiratory infection at 3-month intervals during the first 2 years of life and the development of T1D up to age 10.

A 17% increased risk of T1D was observed among children who had a respiratory infection at any point during the first 6 months of life. From age 0 to 6 months, respiratory infections affected 38.6% of children who later developed T1D, compared with 34.2% of children who didn’t.

Children who experienced respiratory infections in both the 0- to 2.9-month age range and the 3- to 5.9-month range had a greater aggregate 5-year risk for T1D than those who had infections in just 1 of those age ranges or not at all.

Specifically, recurrent viral respiratory infections by age 2 were associated with a more than 2-fold increased risk of T1D by age 5. During the first 2 years of life, at least 1 respiratory infection was reported among 97% of the children who developed T1D, compared with 93% of all children studied.

The researchers noted that the mechanism behind the link between infections and T1D remains unknown, but they postulated that it could reflect “increased exposure to virus or an impairment of the immune system response, perhaps due to genetic susceptibility.”

Apparently, it’s been known for many years that the incidence of T1D is higher during colder months and in Northern climates, leading them to suspect a connection between infections and type 1 diabetes-associated islet-cell autoimmunity.

A 2013 study performed by the same researchers involving 148 children at genetically high-risk of T1D showed that respiratory infections from birth to 6 months were associated with increased risk of T1D-associated islet-cell autoimmunity. A smaller study published that same year looked at 24 children with a family history of type 1 diabetes and found no evidence linking viral infection with rapid-onset T1D.

Taken together, researcher Andreas Beyerlein, PhD, explained toMedscape, “these studies indicate that infections are associated with type 1 diabetes through islet-autoimmunity risk.”

Retail clinicians may be best placed to disseminate this information to parents. Even parents with strong relationships with pediatricians prefer to bring their children to retail clinics for certain conditions, including respiratory infections.

In fact, 74% of parent respondents said they had first considered going to their pediatrician, but ultimately opted to go to a retail clinic because of the convenient hours. Themajorityof retail clinic visits are related to cough, cold, and flu.

Recurrent cases of 2 of the most common types ofacute cough—bronchitis and post-viral cough—may be cause for further observation.