Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Exposure to antibiotics and risk of latent autoimmune diabetes in adults and type 2 diabetes : results from a Swedish case–control study (ESTRID) and the Norwegian HUNT study

Edstorp, Jessica LU ; Rossides, Marios ; Ahlqvist, Emma LU ; Alfredsson, Lars ; Askling, Johan ; Di Giuseppe, Daniela ; Grill, Valdemar ; Sorgjerd, Elin P. ; Tuomi, Tiinamaija LU orcid and Åsvold, Bjørn O. , et al. (2025) In Diabetologia 68(1). p.69-81
Abstract

Aims/hypothesis: Some studies find an increased risk of type 1 diabetes in children exposed to antibiotics. We investigated if exposure to antibiotics increases the risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes. Methods: We used data from a Swedish case–control study (Epidemiological Study of Risk Factors for LADA and Type 2 Diabetes [ESTRID]: LADA, n=597; type 2 diabetes, n=2065; control participants matched on participation time, n=2386) and a case–control study nested within the Norwegian Trøndelag Health Study (HUNT) (n=82/1279/2050). Anatomical Therapeutic Chemical (ATC) codes indicating antibiotic dispensations were retrieved from the Swedish National Prescribed Drug Register and Norwegian Prescription... (More)

Aims/hypothesis: Some studies find an increased risk of type 1 diabetes in children exposed to antibiotics. We investigated if exposure to antibiotics increases the risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes. Methods: We used data from a Swedish case–control study (Epidemiological Study of Risk Factors for LADA and Type 2 Diabetes [ESTRID]: LADA, n=597; type 2 diabetes, n=2065; control participants matched on participation time, n=2386) and a case–control study nested within the Norwegian Trøndelag Health Study (HUNT) (n=82/1279/2050). Anatomical Therapeutic Chemical (ATC) codes indicating antibiotic dispensations were retrieved from the Swedish National Prescribed Drug Register and Norwegian Prescription Database. Multivariable adjusted ORs with 95% CIs were estimated by conditional logistic regression and pooled using fixed-effects inverse-variance weighting. Results: We observed no increased risk of LADA with exposure to antibiotics up to 1 year (ORpooled 1.15, 95% CI 0.93, 1.41) or 1–5 years (ORpooled 0.98, 95% CI 0.80, 1.20) prior to diagnosis/matching for one or more vs no dispensation of any type of antibiotic. An increased risk was observed for one or more vs no dispensations of narrow-spectrum antibiotics, but not broad-spectrum antibiotics, 6–10 years prior to LADA diagnosis (ORpooled 1.39, 95% CI 1.01, 1.91), which was driven by the Swedish data. There was little evidence of an increased risk of type 2 diabetes associated with antibiotic exposure 1–10 years prior to diagnosis. Conclusions/interpretation: We found no evidence that exposure to broad-spectrum antibiotics up to 10 years prior to diagnosis increases the risk of LADA. There was some indication of increased LADA risk with exposure to narrow-spectrum antibiotics, which warrants further investigation. Graphical Abstract: (Figure presented.).

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antibacterial agent, Case–control study, Diabetes mellitus, ESTRID, HUNT, LADA, Latent autoimmune diabetes in adults, Registries, Type 2 diabetes
in
Diabetologia
volume
68
issue
1
pages
69 - 81
publisher
Springer
external identifiers
  • scopus:85207747931
  • pmid:39467872
ISSN
0012-186X
DOI
10.1007/s00125-024-06302-5
language
English
LU publication?
yes
id
b5b79b96-59d8-4af4-8267-77fa08c4ac47
date added to LUP
2024-12-11 09:31:02
date last changed
2025-06-11 23:38:08
@article{b5b79b96-59d8-4af4-8267-77fa08c4ac47,
  abstract     = {{<p>Aims/hypothesis: Some studies find an increased risk of type 1 diabetes in children exposed to antibiotics. We investigated if exposure to antibiotics increases the risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes. Methods: We used data from a Swedish case–control study (Epidemiological Study of Risk Factors for LADA and Type 2 Diabetes [ESTRID]: LADA, n=597; type 2 diabetes, n=2065; control participants matched on participation time, n=2386) and a case–control study nested within the Norwegian Trøndelag Health Study (HUNT) (n=82/1279/2050). Anatomical Therapeutic Chemical (ATC) codes indicating antibiotic dispensations were retrieved from the Swedish National Prescribed Drug Register and Norwegian Prescription Database. Multivariable adjusted ORs with 95% CIs were estimated by conditional logistic regression and pooled using fixed-effects inverse-variance weighting. Results: We observed no increased risk of LADA with exposure to antibiotics up to 1 year (OR<sub>pooled</sub> 1.15, 95% CI 0.93, 1.41) or 1–5 years (OR<sub>pooled</sub> 0.98, 95% CI 0.80, 1.20) prior to diagnosis/matching for one or more vs no dispensation of any type of antibiotic. An increased risk was observed for one or more vs no dispensations of narrow-spectrum antibiotics, but not broad-spectrum antibiotics, 6–10 years prior to LADA diagnosis (OR<sub>pooled</sub> 1.39, 95% CI 1.01, 1.91), which was driven by the Swedish data. There was little evidence of an increased risk of type 2 diabetes associated with antibiotic exposure 1–10 years prior to diagnosis. Conclusions/interpretation: We found no evidence that exposure to broad-spectrum antibiotics up to 10 years prior to diagnosis increases the risk of LADA. There was some indication of increased LADA risk with exposure to narrow-spectrum antibiotics, which warrants further investigation. Graphical Abstract: (Figure presented.).</p>}},
  author       = {{Edstorp, Jessica and Rossides, Marios and Ahlqvist, Emma and Alfredsson, Lars and Askling, Johan and Di Giuseppe, Daniela and Grill, Valdemar and Sorgjerd, Elin P. and Tuomi, Tiinamaija and Åsvold, Bjørn O. and Carlsson, Sofia}},
  issn         = {{0012-186X}},
  keywords     = {{Antibacterial agent; Case–control study; Diabetes mellitus; ESTRID; HUNT; LADA; Latent autoimmune diabetes in adults; Registries; Type 2 diabetes}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{69--81}},
  publisher    = {{Springer}},
  series       = {{Diabetologia}},
  title        = {{Exposure to antibiotics and risk of latent autoimmune diabetes in adults and type 2 diabetes : results from a Swedish case–control study (ESTRID) and the Norwegian HUNT study}},
  url          = {{http://dx.doi.org/10.1007/s00125-024-06302-5}},
  doi          = {{10.1007/s00125-024-06302-5}},
  volume       = {{68}},
  year         = {{2025}},
}