Association of antibiotics exposure within the first 2 years after birth with subsequent childhood type 1 diabetes

Purpose Antibiotics prescription in early life can cause dysbiosis, an imbalance of gut microbiota. We aimed to reveal the relationship between antibiotics exposure during the first 2 years after birth and type 1 diabetes risk in children under 8 years of age using a nationally representative data from South Korea. Methods The final study population consisted of 63,434 children from the National Health Insurance Service (NHIS) database from 2008 to 2015. The primary exposure of interest was antibiotics prescription in first 2 years after birth. The analysis was conducted with cumulative defined daily dose (cDDD; 0-29, 30-59, >= 60 cDDD), the number of antibiotics classes (0-3, 4, >= 5 classes), and age at first antibiotics prescription (0-119, 120-239, >= 240 days). Age, sex, household income, and overweight were considered as potential confounding covariates. Results Compared to those within the less than 30 cDDD, other groups that were prescribed more antibiotics did not have a significant difference in diabetes risk (aHR 0.86, 95% CI 0.37-2.02 in >= 60 cDDD). The number of antibiotics classes and age at first antibiotics prescriptions were also not associated with the risk of type 1 diabetes. The development of diabetes was not related to the cDDD, the number of antibiotics classes, and age at first antibiotics prescription according to subgroup analysis which was stratified by overweight. Conclusions Antibiotics exposure within the first 2 years of life was not associated with subsequent diabetes risk. Future studies using a larger number of long-term follow-up data are needed.