OBJECTIVE: Type 1 diabetes mellitus (T1DM) is an autoimmune disease associated with genetic and environmental factors. Low vitamin D levels and early exposure to cow’s milk protein can affect the occurrence of T1DM. Therefore, we aimed to evaluate low vitamin D levels and early exposure to cow’s milk as risk factors of T1DM.
METHOD: The case-control study was conducted in Dr. Soetomo Hospital during March-May 2019 with participants aged below 18 years old and had been diagnosed T1DM by using the International Society for Pediatric and Adolescent Diabetes (ISPAD). We measured vitamin D serum levels by electrochemiluminescence immunoassay analyzer (ECLIA) with cut off value of deficiency, insufficiency, and sufficiency is <20ng/ml, <30ng/ml, 30-100ng/ml, respectively. The history of cow’s milk exposure in the first three months was evaluated. Statistical analysis using mann-whitney, chi-square, and logistic regression test (considered significant, p<0.05).
RESULT: There were 31 and 24 children in the case and control group, respectively. Exposure to cow’s milk in the first three months in the control group was (12/24) and (16/31) (p=1) in T1DM. In T1DM patient group, 4/31 subjects were found to be deficient in serum vitamin D levels compared to 0/24 of the controls (p<0.05). Collectively, the deficient and insufficient vitamin D status was detected in 24/31 of the T1DM patients compared to 6/24 of the controls (p=0.0003; OR 3.1, 95%CI, 1.5-6.3).
CONCLUSION: Low serum vitamin D level is a risk factor of T1DM but not early cow’s milk exposure.