title: Association of incidence of type 1 diabetes with mortality from infectious disease and with antibiotic susceptibility at a country level.
abstract: To investigate the association between country incidence of type 1 diabetes and mortality from infectious disease and antibiotic susceptibility. An ecological study to explore the relationship at a country level of the reported incidence of type 1 diabetes (DiaMond) to infectious disease mortality (World Health Organisation) and to antibiotic susceptibility (Alexander Project). There were significant negative correlations between the incidence of type 1 diabetes and mortality for all infectious diseases studied. There were also significant positive correlations between the incidence of type 1 diabetes and antibiotic susceptibilities of Strep. pneumoniae, but not to those of Haem. influenzae. Since infectious disease mortality and antibiotic susceptibility are surrogate markers for bacterial exposure, our results provide support for a negative association between bacterial exposure in a community and its incidence of type 1 diabetes. The consistency of our results as well as the highly statistically significant results of most of the associations studied reinforces the validity of our findings.
authors.affiliation: Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, MSD 2090, Malta.
authors.forename: Alexia-Giovanna
authors.initials: AG
authors.lastname: Abela
authors.forename: Stephen
authors.initials: S
authors.lastname: Fava
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications / Q000401:mortality; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology*; D024881:Drug Resistance, Bacterial; D005843:Geography; D006192:Haemophilus Infections / Q000401:mortality; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000401:mortality*; D001936:Moraxella catarrhalis / Q000187:drug effects / Q000302:isolation & purification; D045828:Moraxellaceae Infections / Q000401:mortality; D011008:Pneumococcal Infections / Q000401:mortality; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification; D014944:World Health Organization