To the Editor.
—Although the press coverage that coincided with publication of the article by Dr Norris and colleagues1 indicated that cow's milk was not linked to diabetes, it must be emphasized that these authors actually did not examine the relationship of early exposure to cow's milk protein and development of IDDM. Rather, they examined early eating patterns of first-degree relatives of patients with IDDM who had high plasma levels of autoantibodies to insulin, GAD65, and IA-2. Subjects with high levels of these β-cell autoantibodies (BCAs) were not more likely to have had early exposure to cow's milk protein when compared with the non-BCA subjects. However, the presence of high titers of autoantibodies is not considered a selective predictor of IDDM. Only 5% to 22% of subjects with these antibodies progress to diabetes,2-4 which indicates that β-cell damage may be partial or even reversible in most cases. Norris and colleagues
Johnston CS, Spear SE. Association of Exposure to Cow's Milk Protein and β-Cell Autoimmunity. JAMA. 1996;276(22):1799–1800. doi:10.1001/jama.1996.03540220023013
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