New research says c-sections increase risk of type 1 diabetes in children

[amitymama]

ukpress.google.com/article/ALeqM5gPLhP1cNy0rhGHTmlwkGJYaIjOkA

Just heard about this on the news and found the link. It basically says that a new study shows that babies born by caesarean have a 23% higher risk of developing type 1 diabetes because they are not exposed to maternal bacteria in a vaginal delivery but instead the hospital's bacteria, which means their but flora and immunity can be effected. The Diabetes Association (not sure if that's its exact name) says that they have been looking at how gut flora is involved in the incidence of diabetes and think the link could very well be valid.

Thoughts?

[bramblebooks]

Just passing through to clarify that I was quoting p&l saying it was by specialists, my comment was the 'weight' bit - as when a meta-analysis is being carried out, part of the research is careful selection of reliable sources. My lack of clearer analysis comes from having been up every 2 hours through the night testing my 8 year old's blood glucose levels. (non-caesar, breastfed, vegetarian!).

Sadly I no longer have an athens username and password as I completed my masters in Feb and no longer have access to the uni library I look forwards to reading the article, but will have to get hold of hardcopy.

[InTheDollshouse]

fair enough, it's just that earlier you said "just read the abstract. the major problem in this scare-mongering, sorry meta-analysis is that this is not new research, they are just rehashing existing statistics so if the existing statistics are flawed, this article is mince." which sounds fairly dismissive to me, and implied that you'd just read the abstract and not the paper itself.

I completely agree that the media often read too much into research conclusions whereas the researchers themselves are generally much more conservative. However, I think it was unfair of you to describe the research as "scare-mongering", when, as you yourself point out, the researchers urged caution in interpreting the results.

[fledtoscotland]

yes i have. I am not dismissing it but saying, as agreed in the conclusions, that further research is needed to find out why there is the possible link. The paper is available through Athens and all NHS nursing staff are entitled to a athens username & password.

Am sorry if people disagree but its a pet hate that the media jump to conclusions and then publish these conclusions. Yes it is important to find out if T1 can be linked to C-sections as the UK has quite a high CS rate compared to other developed countries.

[InTheDollshouse]

fledtoscotland, have you read the paper? You seem awfully keen to dismiss it on the abstract alone.

[fledtoscotland]

P&L - i actually missed the bit saying it was you who said about it should carry some weight. I was quoting Bramblebrooks's post. Also my original comments about scaremongering were not to do with the actual article but the media's interpretation of it as in the OP.

[PortAndLemon]

Sheesh.

Yes, fledtoscotland, I AGREE WITH YOU. As I said, "this is the sort of 'hmm, that's interesting' article that is designed to inspire someone to go off and do a properly designed and controlled study, rather than one that reaches profound conclusions in its own right."

• I don't think this study has "particular weight".

• I also don't think it is "scaremongering".

• I said that I didn't think it was scaremongering.

• I was quoted as saying that I thought it had weight.

I was attempting to clarify this misrepresentation of my views.

The example about going to the park was an attempt to lightheartedly illustrate (in a reductio ad absurdum way) that it is perfectly possible for something to be both (a) not scaremongering and (b) not weighty, so that saying that something is not scaremongering isn't the same as saying that it has weight (given that there seemed to have been some confusion on that point).

I don't particularly want you to say anything more, although if you want we can sit around on this thread agreeing with each other all day.

[fledtoscotland]

totally agree with TBB - there is a known link between FF & T1 so maybe thats the connection as C-sections have a lower rate of exclusive BF than VBs.

i think primary qualitative research is needed before we take these findings literally.

[Tittybangbang]

"formula in relation to the research on gd"

sorry - meant type 1 diabetes not gd...

[Tittybangbang]

I would be very interested to look at the details of this study. They say they controlled for breastfeeding, but I wonder how strictly this was the case? My understanding of the link between bf and reduced rates of diabetes is that bf has got to be exclusive - it's early exposure to the proteins in cows milk that I thought triggered diabetes in some susceptible children, not protective factors in breastmilk (if you see what I mean).

In our local hospital around 50% of bf babies have been supplemented with formula before leaving hospital. I would think this is more likely to be the case for C/S mothers, whose babies are perhaps more likely to have been separated from them. Their mothers may still go on to say they have 'exclusively breastfed' if they are not fully aware of the possible significance of their baby having had formula in relation to the research on gd . I've also seen research showing that mothers can have very poor recall of how much and how often their bf babies have had formula.

[fledtoscotland]

not entirely sure what you going to the park has to do with meta-analysis as meta-analysis is a type of research (and not even primary research) and you commenting to other mums on your intentions is purely that - commenting on your intentions.

My point is that the study itself states that it is unwise to read too much into the results. What more can i say?

[PortAndLemon]

I never said "because it was written by specialists then it must have weight". I said that because it was written by specialists for specialists (who are well aware of all the different theories about reasons for the rise in type 1 diabetes, and who also know the strengths and weaknesses of a meta-analysis) then it's unlikely to be scaremongering.

Not being scaremongering isn't the same thing as having weight.

If I say "I'm popping down to the park with DS this afternoon" then that isn't scaremongering, but it has no particular weight. If I say it to my mother, who then tells her friends that I'm going to walk DS to the park and I won't make him hold my hand every step of the way and so he runs a huge risk of being run over, then that's scaremongering (and still doesn't have any weight).

I suspect this meta-analysis has more weight than my taking DS to the park this afternoon (especially as it looks like rain so I probably won't ), but it's interesting rather than profound.

[fledtoscotland]

"The research examined 20 published studies of 9,900 children with Type 1 diabetes born by Caesarean section" - it was only looking at the research already linking T1 to C-sections.

however the conclusions also state

"Dr Chris Patterson said: ?The study findings are interesting, but unless a biological mechanism is established it would be unwise to read too much into this association between Caesarean section delivery and diabetes."

[fledtoscotland]

dramasequalzero - it can be more powerful, however any discrepancies/bias from the original statistics will be carried forward to the next conclusions. Just because it is larger numbers does not make it more accurate.

[InTheDollshouse]

When researchers conduct a meta-analysis, they examine the design of the original papers and only include ones that are well-designed. The value of a meta-analysis is that you can look at much larger numbers, making it much more powerful.

[fledtoscotland]

sorry should be "jump to conclusions"

my major concern is that people are going to panic that "gran had diabetes" and therefore my LO will. i hate media coverage of things like this as they dont differentiate between T1 & T2 and the risk factors

[bramblebooks]

fled - good point. I'd like to see evidence of the sample used.

[Purplepillow]

Athene, no none of them are over weight, they were the first diabetics in our family although three of the grandparent have since been diagnosed with T2 diabetes.

I have a quite large family and only five were born by cs, all the rest are fine(so far) my dd was also born by cs so keeping an eye on her, but no signs yet thank goodness

[fledtoscotland]

totally disagree that "because it was written by specialists then it must have weight"

it you consider the type of research it is, you will find that meta-analysis is the use of current statistics. all that is being done is changing the current interpretation of the statistics. The major problem with this is that if the statistics are biased, the new report will also contain this bias.

It is an interesting discussion but i feel primary research should be carried out before we all just to conclusions of our own.

[FlightAttendent]

Athene - as far as I am aware, yes it is more likely you'll have a section if you have diabetes. I'm not sure why this is.

[bramblebooks]

My ds2 has type 1 diabetes. No one else in our family has it. He has a genetic pre-disposition to it as my OH has coeliac disease (it's in a cluster of auto-immune diseases). Our specialist says it was probably triggered by a virus (just a cold!) when he was a baby.

It presented last year when he was 7. Symptoms: weight loss, tiredness, stomach pains, pear drops smell on breath, lots of wees, wet bed, excessive thirst, anxiety.

We now have an insulin pump and I have my little boy back.

We have been discussing this report in our support group. Very few of the women had c sections (I didn't count, but it was noticable compared to what the report said). Most of us had v births. However, as P&L said ^^ it was written by specialists, so must have 'weight'.

Athene - there is a genetic pre-disposition to diabetes, t1, but it is nothing to do with lifestyle, weight, etc. T2 is a completely different issue and is affected by lifestyle issues.

[AtheneNoctua]

Purple are there any other relevant variables? Like, does diabetes run in the family? Are they overweight?

[Purplepillow]

I have two nieces and a nephew who were all born by cs and have all developed t1 diabetes although all at different ages.

[PortAndLemon]

I don't think the article itself is scaremongering. After all, it's written by diabetes specialists (who would quite like to genuinely find out what causes diabetes, even if only because they'd be in with a shot of a Nobel Prize if they did) in a specialist diabetes journal with a circulation of other diabetes specialists.

Press coverage of it is scaremongering, absolutely. But then that's usually the case with news reporting of any academic paper - there's an unwritten rule that it must be used as the basis for either scaremongering or trivialisation, and if neither of those is possible the research must be ridiculed by spectacularly missing the point.

[fledtoscotland]

just read the abstract. the major problem in this scare-mongering, sorry meta-analysis is that this is not new research, they are just rehashing existing statistics so if the existing statistics are flawed, this article is mince.

[tangarine]

ds1 was a vb and developed T1 aged 5.