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Exposure to antibiotics and risk of latent autoimmune diabetes in adults and type 2 diabetes: results from a Swedish case–control study (ESTRID) and the Norwegian HUNT study
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Exposure to antibiotics and risk of latent autoimmune diabetes in adults and type 2 diabetes: results from a Swedish case–control study (ESTRID) and the Norwegian HUNT study
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Journal Article
Exposure to antibiotics and risk of latent autoimmune diabetes in adults and type 2 diabetes: results from a Swedish case–control study (ESTRID) and the Norwegian HUNT study
2025
Overview
Aims/hypothesis
Some studies find an increased risk of type 1 diabetes in children exposed to antibiotics. We investigated if exposure to antibiotics increases the risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes.
Methods
We used data from a Swedish case–control study (Epidemiological Study of Risk Factors for LADA and Type 2 Diabetes [ESTRID]: LADA,
n
=597; type 2 diabetes,
n
=2065; control participants matched on participation time,
n
=2386) and a case–control study nested within the Norwegian Trøndelag Health Study (HUNT) (
n
=82/1279/2050). Anatomical Therapeutic Chemical (ATC) codes indicating antibiotic dispensations were retrieved from the Swedish National Prescribed Drug Register and Norwegian Prescription Database. Multivariable adjusted ORs with 95% CIs were estimated by conditional logistic regression and pooled using fixed-effects inverse-variance weighting.
Results
We observed no increased risk of LADA with exposure to antibiotics up to 1 year (OR
pooled
1.15, 95% CI 0.93, 1.41) or 1–5 years (OR
pooled
0.98, 95% CI 0.80, 1.20) prior to diagnosis/matching for one or more vs no dispensation of any type of antibiotic. An increased risk was observed for one or more vs no dispensations of narrow-spectrum antibiotics, but not broad-spectrum antibiotics, 6–10 years prior to LADA diagnosis (OR
pooled
1.39, 95% CI 1.01, 1.91), which was driven by the Swedish data. There was little evidence of an increased risk of type 2 diabetes associated with antibiotic exposure 1–10 years prior to diagnosis.
Conclusions/interpretation
We found no evidence that exposure to broad-spectrum antibiotics up to 10 years prior to diagnosis increases the risk of LADA. There was some indication of increased LADA risk with exposure to narrow-spectrum antibiotics, which warrants further investigation.
Graphical Abstract
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Adults
/ Aged
/ Anti-Bacterial Agents - adverse effects
/ Anti-Bacterial Agents - therapeutic use
/ Diabetes
/ Diabetes mellitus (insulin dependent)
/ Diabetes mellitus (non-insulin dependent)
/ Diabetes Mellitus, Type 1 - chemically induced
/ Diabetes Mellitus, Type 1 - drug therapy
/ Diabetes Mellitus, Type 1 - epidemiology
/ Diabetes Mellitus, Type 2 - drug therapy
/ Diabetes Mellitus, Type 2 - epidemiology
/ Female
/ Humans
/ Latent Autoimmune Diabetes in Adults - epidemiology
/ Male
/ Medicine
