Cow's Milk Exposure and Type I Diabetes Mellitus: A critical overview of the clinical literature
- Hertzel C Gerstein, MD, MSC, FRCPC
- Division of Endocrinology and Metabolism, Department of Medicine, McMaster University Hamilton, Ontario, Canada
- Address correspondence and reprint requests to Hertzel C. Gerstein, MD, McMaster Medical Clinics, 3rd Floor, Henderson General Hospital, 711 Concession Street, Hamilton, Ontario, Canada L8V 1C3.
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 metaanalyzed 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 ∼1.5 times.
- Received March 8, 1993.
- Revision received June 10, 1993.
- Accepted June 10, 1993.
- Copyright © 1994 by the American Diabetes Association