ArticleInternational journal of environmental research and public health2022
Birth Order, Caesarean Section, or Daycare Attendance in Relation to Child- and Adult-Onset Type 1 Diabetes: Results from the German National Cohort.
Article in International journal of environmental research and public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Impact of integrative therapies on glycemic control in type 1 diabetes: a systematic review and global research landscape.Frontiers in clinical diabetes and healthcare · 2026Pooled it
- Lifestyle and environmental risk factors for adult-onset autoimmune diabetes: current evidence and future directions.Diabetologia · 2026Review
- Can synthetic data reproduce real-world findings in epidemiology? A replication study using adversarial random forests.International journal of epidemiology · 2026Article
- Childhood maltreatment and adult diseases in the general population: the mediating role of smoking and overweight in a time-sequence design.BMC public health · 2025Article
- Birth order, daycare attendance, and childhood socioeconomic status in relation to gingivitis: a cross-sectional study in Turkish young adults.BMC oral health · 2024Observational
Corrections and comments
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Authors and funding
30 authors at 16 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
(1) Background: Global incidence of type 1 diabetes (T1D) is rising and nearly half occurred in adults. However, it is unclear if certain early-life childhood T1D risk factors were also associated with adult-onset T1D. This study aimed to assess associations between birth order, delivery mode or daycare attendance and type 1 diabetes (T1D) risk in a population-based cohort and whether these were similar for childhood- and adult-onset T1D (cut-off age 15); (2) Methods: Data were obtained from the German National Cohort (NAKO Gesundheitsstudie) baseline assessment. Self-reported diabetes was classified as T1D if: diagnosis age ≤ 40 years and has been receiving insulin treatment since less than one year after diagnosis. Cox regression was applied for T1D risk analysis; (3) Results: Analyses included 101,411 participants (100 childhood- and 271 adult-onset T1D cases). Compared to "only-children", HRs for second- or later-born individuals were 0.70 (95% CI = 0.50-0.96) and 0.65 (95% CI = 0.45-0.94), respectively, regardless of parental diabetes, migration background, birth year and perinatal factors. In further analyses, higher birth order reduced T1D risk in children and adults born in recent decades. Caesarean section and daycare attendance showed no clear associations with T1D risk; (4) Conclusions: Birth order should be considered in both children and adults' T1D risk assessment for early detection.
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