Diabetes Care, Vol 17, Issue 1 13-19, Copyright © 1994 by American Diabetes Association

ARTICLES

Cow's milk exposure and type I diabetes mellitus. A critical overview of the clinical literature

HC Gerstein
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

OBJECTIVE--To critically review and summarize the clinical evidence relating a short duration of breast-feeding or early cow's milk exposure to insulin-dependent (type I) diabetes. RESEARCH DESIGN AND METHODS--All relevant citations retrieved through comprehensive searching of the medical literature were critically reviewed and analyzed. Those case-control studies that minimized the possibility of bias were meta-analyzed to determine overall odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS--Ecological and time-series studies consistently showed a relationship between type I diabetes and either cow's milk exposure or diminished breast-feeding. In the case-control studies, patients with type I diabetes were more likely to have been breast-fed for < 3 months (overall OR 1.43; 95% CI 1.15-1.77) and to have been exposed to cow's milk before 4 months (overall OR 1.63; 95% CI 1.22-2.17). Slightly lower ORs were obtained when all of the case-control studies were meta-analyzed in a sensitivity analysis. CONCLUSIONS--Early cow's milk exposure may be an important determinant of subsequent type I diabetes and may increase the risk approximately 1.5 times.
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