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Environmental factors predisposing to type 1 diabetes mellitus in children: A descriptive study of various pediatric endocrine clinics in Jeddah, Saudi Arabia.

Abdulmoein Eid Al-Agha*, Abdulrhman Mohammad Banasser, Rayan Ali Alghamdi, Hesham Fouad Barradah, Saleh Jameel Almatrafi, Ibrahim Musnef K Alyazidi, Abdullah Sabti S Almoeirfi

Background: There is increasing incidence of Type 1 Diabetes Mellitus (T1DM), an autoimmune disease that destroys pancreatic beta cells and is caused by multiple environmental factors. This increasing incidence has been associated with different factors. We aimed to investigate the relationship between environmental factors, such as vitamin D deficiency, socioeconomic status, maternal age, low birth weight, mode of delivery, and breastfeeding; and T1DM. In addition, we critically discussed environmental factors promoting the progression to T1DM. Methods: We analyzed data of 250 children and adolescents aged<18 years who were selected through a random sampling technique. Descriptive data were collected from various ambulatory pediatric endocrine clinics in Jeddah city by reviewing both the medical records of patients and the phoenix system. Results: The 250 patients included 125 boys and 125 girls with T1DM. Evaluation of environmental factors revealed that 111 (44.4%) patients had low vitamin D levels, 106 (42.4%) had good income, 140 (56.7%) had maternal age>30 years at delivery, 190 (76%) had normal birth weight, 173 (69.2%) were delivered through vaginal birth, 72 of 117 patients were breast and bottle fed, and 72 of 142 patients were fed for 1-2 years after birth. Conclusions: There was a significant association between environmental factors and increased risk of T1DM. The most common environmental factors that increased the risk of T1DM were maternal age>30 years and low vitamin D levels in the infant as well as good or average socioeconomic status.