Day care attendance linked to lower T1D risk in children

Children attending day care appear to be less likely than those who do not to have type 1 diabetes (T1D), according to the results of a meta-analysis.

Researchers searched multiple online databases for studies in which the association between day care attendance and risk of T1D was investigated. They extracted details such as exposure and outcome assessment and adjustment for confounders from the studies. Meta-analyses were performed usin DerSimonian and Laird random-effects models.

The meta-analysis included a total of 22 observational studies involving 100,575 participants. The main outcome measure was T1D risk in relation to day care attendance vs no day care attendance.

Of the participants, 3,693 had T1D and the remaining 96,882 served as controls. Pooled data showed that day care attendance was associated with 32-percent lower odds of T1D (combined odds ratio [OR], 0.68, 95 percent CI, 0.58-0.79; p<0.001; adjusted for all available confounders).

When the three cohort studies included were analysed individually, the association was attenuated. The group of children attending day care had 15-percent lower odds of T1D compared with the group that did not attend day care, but the difference was not statistically significant (odds ratio, 0.85, 95 percent CI, 0.59–1.12; p=0.37).

The association may be explained by increased contacts with microbes in children attending day care, according to the researchers. However, additional prospective cohort studies are needed to confirm the association.