Evidence map›Paper›PMID 38819466›Full record

ArticleDiabetologia2024

Caesarean section and risk of type 1 diabetes.

Tarini Singh, Andreas Weiss, Kendra Vehik, Jeffrey Krischer, Marian Rewers, Jorma Toppari, Åke Lernmark, William Hagopian, Beena Akolkar, Ezio Bonifacio and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetologia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Tarini SinghInstitute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.ORCID http://orcid.org/0009-0006-0638-6882
Andreas WeissInstitute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.ORCID http://orcid.org/0000-0001-9597-0576
Kendra VehikHealth Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.ORCID http://orcid.org/0000-0001-6243-6772
Jeffrey KrischerHealth Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.ORCID http://orcid.org/0000-0003-4526-888X
Marian RewersBarbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA.ORCID http://orcid.org/0000-0003-3829-9207
Jorma ToppariDepartment of Pediatrics, Turku University Hospital, Turku, Finland.ORCID http://orcid.org/0000-0003-2228-334X
Åke LernmarkDepartment of Clinical Sciences, Lund University/CRC, Skåne University Hospital SUS, Malmo, Sweden.ORCID http://orcid.org/0000-0003-1735-0499
William HagopianPacific Northwest Research Institute, Seattle, WA, USA.ORCID http://orcid.org/0000-0003-2979-0475
Beena AkolkarNational Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.ORCID http://orcid.org/0000-0002-2351-5942
Ezio BonifacioTechnische Universität Dresden, Center for Regenerative Therapies Dresden, Dresden, Germany.ORCID http://orcid.org/0000-0002-8704-4713
Anette-G ZieglerInstitute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.ORCID http://orcid.org/0000-0002-6290-5548
Christiane WinklerInstitute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany. christiane.winkler@helmholtz-munich.de.ORCID http://orcid.org/0000-0002-7606-3687
TEDDY Study Group

Funding

Limited Competition: Continued Follow-up of Subjects and Initiation of a Second Case-control Cohort in The Environmental Determinants of Diabetes in The Young Study (TEDDY)U01DK128847 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI JEFFREY P KRISCHER · 2021 to 2026
$79.2M
Data Coordinating Center (DCC)for the Consortium for Identification of EnvironmenUC4DK095300 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2011 to 2011
$56.0M
NIH Prior Approval Process ProfessionalUL1TR002535 · NCATS · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2018 to 2022
$51.1M
Data Coordinating CenterU01DK063790 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2002 to 2006
$50.1M
Follow-up on Subjects, Integrative Data Analysis and Measurement of Viral Antibodies in The Environmental Determinants of Diabetes in The Young Study (TEDDY)U01DK124166 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2020 to 2022
$31.1M
NIDDK Follow-up on Subjects and Immunological Assessments in The Environmental Determinants of Diabetes In The Young Study (TEDDY) (UC4)UC4DK117483 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2017 to 2020
$30.4M
Establish a Data Coordinating Center (DCC) for the Consortium for Identification UC4DK100238 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2014 to 2014
$28.9M
The Study of Epigenetics and Infections in The Environmental Determinants of Diabetes in the Young (TEDDY)UC4DK112243 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2016 to 2016
$27.0M
Data Coordinating Center (DCC) for the Consortium for Identification of Environmental Determinants of Diabetes in the Young (TEDDY) StudyUC4DK106955 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2015 to 2015
$20.0M
The Environmental Determinants of Diabetes in Young (TEDDY0U01DK063863 · NIDDK · HOSPITAL DISTRICT OF SOUTHWEST FINLAND · PI TOPPARI, JORMA · 2003 to 2022
$13.5M
The Environmental Triggers of Diabetes (TEDDY) in SwedenU01DK063861 · NIDDK · UNIVERSITY OF WASHINGTON · PI LERNMARK, AKE · 2003 to 2022
$13.4M
THE TEDDY STUDY - COLORADO CLINICAL CENTERU01DK063821 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI REWERS, MARIAN J · 2003 to 2022
$12.3M
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) U01 DK63821National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) U01 DK63829National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) U01 DK63861National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) U01 DK63865NCATS NIH HHS UL1 TR000064NCATS NIH HHS UL1 TR002535NIDDK NIH HHS U01 DK063790NIDDK NIH HHS U01 DK063821NIDDK NIH HHS U01 DK063829NIDDK NIH HHS U01 DK063836NIDDK NIH HHS U01 DK063861NIDDK NIH HHS U01 DK063863NIDDK NIH HHS U01 DK063865NIDDK NIH HHS U01 DK124166NIDDK NIH HHS U01 DK128847NIDDK NIH HHS UC4 DK063821NIDDK NIH HHS UC4 DK063829NIDDK NIH HHS UC4 DK063836NIDDK NIH HHS UC4 DK063861NIDDK NIH HHS UC4 DK063863NIDDK NIH HHS UC4 DK063865NIDDK NIH HHS UC4 DK095300NIDDK NIH HHS UC4 DK100238NIDDK NIH HHS UC4 DK106955NIDDK NIH HHS UC4 DK112243NIDDK NIH HHS UC4 DK117483NLM NIH HHS HHSN267200700014C
6 · The paper itself

Abstract

aims/hypothesisDelivery by Caesarean section continues to rise globally and has been associated with the risk of developing type 1 diabetes and the rate of progression from pre-symptomatic stage 1 or 2 type 1 diabetes to symptomatic stage 3 disease. The aim of this study was to examine the association between Caesarean delivery and progression to stage 3 type 1 diabetes in children with pre-symptomatic early-stage type 1 diabetes.

methodsCaesarean section was examined in 8135 children from the TEDDY study who had an increased genetic risk for type 1 diabetes and were followed from birth for the development of islet autoantibodies and type 1 diabetes.

resultsThe likelihood of delivery by Caesarean section was higher in children born to mothers with type 1 diabetes (adjusted OR 4.61, 95% CI 3.60, 5.90, p<0.0001), in non-singleton births (adjusted OR 4.35, 95% CI 3.21, 5.88, p<0.0001), in premature births (adjusted OR 1.91, 95% CI 1.53, 2.39, p<0.0001), in children born in the USA (adjusted OR 2.71, 95% CI 2.43, 3.02, p<0.0001) and in children born to older mothers (age group >28-33 years: adjusted OR 1.19, 95% CI 1.04, 1.35, p=0.01; age group >33 years: adjusted OR 1.80, 95% CI 1.58, 2.06, p<0.0001). Caesarean section was not associated with an increased risk of developing pre-symptomatic early-stage type 1 diabetes (risk by age 10 years 5.7% [95% CI 4.6%, 6.7%] for Caesarean delivery vs 6.6% [95% CI 6.0%, 7.3%] for vaginal delivery, p=0.07). Delivery by Caesarean section was associated with a modestly increased rate of progression to stage 3 type 1 diabetes in children who had developed multiple islet autoantibody-positive pre-symptomatic early-stage type 1 diabetes (adjusted HR 1.36, 95% CI 1.03, 1.79, p=0.02). No interaction was observed between Caesarean section and non-HLA SNPs conferring susceptibility for type 1 diabetes. CONCLUSIONS/

interpretationCaesarean section increased the rate of progression to stage 3 type 1 diabetes in children with pre-symptomatic early-stage type 1 diabetes. DATA AVAILABILITY: Data from the TEDDY study ( https://doi.org/10.58020/y3jk-x087 ) reported here will be made available for request at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repository (NIDDK-CR) Resources for Research (R4R) ( https://repository.niddk.nih.gov/ ).

Indexed as

Cesarean SectionDiabetes Mellitus, Type 1AdultAutoantibodiesChildChild, PreschoolDisease ProgressionFemaleHumansInfant, NewbornMalePregnancyRisk FactorsAutoantibodiesCaesarean sectionProgressionType 1 diabetesType 1 diabetes susceptibility genes

Identifiers

PMID38819466
PMCPMC11343945

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.