REFILE: Higher education tied to rare form of diabetes

NEW YORK (Reuters Health) - People who attend college may be at greater risk of developing a less common form of diabetes associated with autoimmunity, new study findings suggest.

Among more than 56,000 adults living in Norway, those who reached university were nearly twice as likely as adults who did not finish high school to develop autoimmune diabetes - an adult form of the disease similar to the type 1 diabetes that typically manifests in childhood.

Clearly, higher education itself does not increase the risk of autoimmune diabetes, study author Lisa Olsson of the Karolinska Institutet in Sweden told Reuters Health. Rather, these results suggest that people who go to university have some other factor in their lives that predisposes them to this type of diabetes, she explained.

"Subjects with high education may have a different lifestyle (or) be exposed to other environmental factors than people with low education, which may increase their risk," Olsson said in an e-mail.

She added that she and her colleagues used statistical tools to eliminate the influence of traditional risk factors - such as a family history of diabetes, obesity, smoking and lack of exercise - from the results, published in Diabetes Care. "Other environmental factors must be involved in the explanation of these associations," Olsson noted.

Furthermore, the risk of developing autoimmune diabetes was relatively low - out of more than 56,000 adults, only 122 were diagnosed with autoimmune diabetes. In contrast, more than 1,500 developed the more common form of the disease, type 2, which is closely related to obesity.

In autoimmune diabetes, the immune system destroys beta cells, which are responsible for producing insulin. When diagnosed in children, it is called type 1 diabetes. In some cases, the loss of beta cells progresses slowly, causing the disease to appear for the first time in adults, when it is described as latent autoimmune diabetes in adults (LADA). Up to 12% of adults newly diagnosed with diabetes have the LADA form of the disease.

Previous research has found that children from higher socioeconomic backgrounds appear to be more likely to develop type 1 diabetes. This study - which reviewed data collected from 56,296 people over 24 years -- suggests that the link between higher education and autoimmune diabetes is present in adults, as well.

One possible explanation for the link between LADA and higher education, Olsson noted, is that adults who have the means to attend university may experience fewer infections in childhood, which some researchers suspect predisposes children to type 1 diabetes. "Based on the findings in our study, we speculate that the risk of autoimmune diabetes in adults may also be affected by environmental factors and exposure to infections in early life," she said. "But other environmental factors, operating at adult age, may also be involved."

Dr. Olov Rolandsson, who studies diabetes at Umea University in Sweden, agreed that the explanation for the link between higher education and autoimmune diabetes remains mysterious. This type of study does not show "cause and effect," but is still very valuable, he added. "If it becomes a pattern that certain groups have a higher risk of disease, the scientists can focus their efforts to study these groups more carefully in order to identify a specific 'culprit' eventually," he said in an e-mail to Reuters Health.

SOURCE: link.reuters.com/fat79p Diabetes Care, online October 11, 2010.