To the Editor A research letter by Dr Beyerlein and colleagues focused on infections in early life and the risk of developing type 1 diabetes (T1D) in a large pediatric cohort.1 We would like to address some relevant points about this study.
The authors did not assess some early determinants, such as gestational age, feeding practice (ie, breastfeeding), and perinatal use of antibiotics. These factors influence both gut development and function,2 the risk of infections, and the consequent risk of T1D.
Rahmoune H, Boutrid N, Bioud B. Association of Infection in Early Life and Risk of Developing Type 1 Diabetes. JAMA. 2016;316(8):882. doi:10.1001/jama.2016.10285