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Diabetes Autoimmunity Study in the Young (DAISY)

Jill M. Norris, PhD; Brenda Beaty, MSPH; Georgeanna Klingensmith, MD; Liping Yu, MD; Michelle Hoffman, RN; H. Peter Chase, MD; Henry A. Erlich, PhD; Richard F. Hamman, MD; George S. Eisenbarth, MD; Marian Rewers, MD

JAMA. 1996;276(8):609-614.

Abstract
Objective.
—To examine whether infant dietary exposure to cow's milk is associated with β-cell autoimmunity (BCA), an early predictor of insulin-dependent diabetes mellitus (IDDM).

Setting.
—Denver, Colo.

Design.
—Cross-sectional with retrospective analysis.

Participants.
—Between January 1994 and December 1995, 253 children from 171 families of persons with IDDM were screened for BCA. All children were between the ages of 9 months and 7 years.

Main Outcome Measures.
—BCA was defined as elevated levels of insulin autoantibody, glutamic acid decarboxylase autoantibody, or insulinoma-associated islet tyrosine phosphatases autoantibody (IA-2) above the 99th percentile of 198 normal subjects.

Results.
—Eighteen cases of BCA were detected; 153 unrelated autoantibodynegative children were selected from the cohort as controls. There were no differences in the proportion of cases and controls who were exposed to cow's milk or foods containing cow's milk or to cereal, fruit and vegetable, or meat protein by 3 months or by 6 months of age. Children with BCA were breast-fed for a slightly longer duration than controls (median duration 10 vs 8 months, P=.07).

Conclusions.
—These data suggest that early exposure to cow's milk or other dietary protein is not associated with BCA. This calls into question the importance of cow's milk avoidance as a preventive measure for IDDM.

Author Affiliations
From the Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, Denver (Drs Norris, Hamman, and Rewers and Mss Beaty and Hoffman); The Barbara Davis Center for Childhood Diabetes, Denver, Colo (Drs Klingensmith, Yu, Chase, and Eisenbarth); and the Department of Human Genetics, Roche Molecular Systems, Inc, Alameda, Calif (Dr Erlich).

Footnotes
Reprints: Jill M. Norris, PhD, Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, 4200 E Ninth Ave, Box C-245, Denver, CO 80262.

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