C Section Delivery Increases Risk for Type 1 Diabetes

Babies delivered by Caesarean section (C-section) are significantly more likely to develop type 1 diabetes, according to a recent study. This observation could help explain how this poorly understood disease develops.

Type 1 diabetes often develops early in life (hence the alternative name, juvenile diabetes), and is characterized by the destruction of insulin producing beta cells by the immune system. The subsequent deficiency of insulin makes for an inability to regulate blood glucose levels, which if not maintained by external insulin injections, can lead to serious complications, and even death. Statistics vary on how many people in the United States are living with type 1 diabetes, but the number is thought to be as high as 2 million, with 15-20 thousand new childhood diagnoses each year.

There are various risk factors associated with the development of type 1 diabetes, though the definitive reason and moment for its development are poorly understood. Some of these risk factors include genetics, infections, birth weight, breast feeding habits, and whether the mother had gestational diabetes (sustained elevated blood glucose levels during pregnancy).

In the current study, even when accounting for all these known risk factors, it was found that children delivered by C-section were 20% more likely to have type 1 diabetes than those delivered vaginally. The study was performed by analyzing data from over 10,000 children with type 1 diabetes and more than one million control children (those without type 1 diabetes). This data came from 20 past studies, performed in various parts of the world.

A possible explanation for this finding was offered by Dr. Chris Cardwell, one of the studies authors: “Caesarean section may affect the development of the immune system because babies are first exposed to bacteria originating from the hospital environment rather than to maternal bacteria.” Because the immune system is responsible for destroying pancreatic beta-cells in type 1 diabetics, this initial disruption to immune system development could trigger this harmful mechanism.

The explanation offered in the study are still very speculative however, and beyond finding a statistical correlation, it’s hard to say that this study does more than lay the foundations for further research into the matter. “This study revealed a consistent 20 per cent increase in the risk of Type 1 diabetes. It is important to stress that the reason for this is still not understood. It is possible that children born by Caesarean section differ from other children with respect to some unknown characteristic which consequently increases their risk of diabetes, but it is also possible that Caesarean section itself is responsible,” concludes Dr. Cardwell.

Source: Defeat Diabetes Foundation: Cardwell, Chris. Clements, Andrea. Queens University Belfast news release. August 2008.