There are indications that the effect of environmental factors on the risk of type 1 diabetes mellitus (T1DM) is increasing
over time. This can be documented by the rapid increase of T1DM incidence in genetically stable populations. Our aim was to
study an association of T1DM with the variable factors of the perinatal period and of early infancy, using data from children
born over a period of changing exposure to some of the studied factors. A case–control dataset was analysed, consisting of
868 diabetic children and 1,466 anonymous controls, mostly schoolmates of the children with T1DM. The data were collected
using structured questionnaires completed by parents. After performing univariate analyses, the associations were analysed
using multiple logistic regression adjusted for potential confounders, including the year of birth. The risk of T1DM decreased
with increasing duration of breast-feeding, while no breast-feeding was associated with an increased T1DM risk, OR=1.93 [95%
CI: 1.33–2.80], breast-feeding for more than 12 months was protective, OR=0.42 [95% CI: 0.22–0.81], both being relative to
the reference category of breast-feeding for 1–3 months. A short duration of day-care attendance (none or less than 1 year)
was weakly associated with the risk of T1DM, OR=1.65 [95% CI: 1.05–2.62]. No association was detected between T1DM and signs
of prenatal infections, perinatal stress factors, birth size and weight, indicators of crowding or the presence of a domestic
pet in the household. Short breast-feeding period and short attendance to day care is associated with the risk of T1DM in
Czech children.
Keywords Diabetes mellitus - Type 1 - Epidemiology - Risk factors - Infant nutrition