Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Diabetologia
Published in: Diabetologia 8/2008

01-08-2008 | Article

The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide

Authors: S. B. Mohr, C. F. Garland, E. D. Gorham, F. C. Garland

Published in: Diabetologia | Issue 8/2008

Login to get access

Abstract

Aims/hypothesis

This study is an analysis of the relationship between ultraviolet B (UVB) irradiance, the primary source of circulating vitamin D in humans, and age-standardised incidence rates of type 1 diabetes mellitus in children, according to region of the world.

Methods

The association of UVB irradiance adjusted for cloud cover to incidence rates of type 1 diabetes in children aged <14 years during 1990–1994 in 51 regions worldwide was assessed using multiple regression. Incidence data were obtained from the Diabetes Mondial Project Group.

Results

Incidence rates were generally higher at higher latitudes (R 2 = 0.25, p < 0.001). According to multiple regression, UVB irradiance adjusted for cloud cover was inversely associated with incidence rates (p < 0.05), while per capita health expenditure (p < 0.004) was positively associated (overall R 2 = 0.42, p < 0.0001).

Conclusions/interpretation

An association was found between low UVB irradiance and high incidence rates of type 1 childhood diabetes after controlling for per capita health expenditure. Incidence rates of type 1 diabetes approached zero in regions worldwide with high UVB irradiance, adding new support to the concept of a role of vitamin D in reducing the risk of the disease.
Literature
1.
Eiselein L, Schwartz HJ, Rutledge JC (2004) The challenge of type 1 diabetes mellitus. ILAR J 45:231–236PubMed
2.
Jahromi MM, Eisenbarth GS (2007) Cellular and molecular pathogenesis of type I diabetes. Cell Mol Life Sci 64:865–872PubMedCrossRef
3.
Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J (2000) Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 23:1516–1526PubMedCrossRef
4.
Adams JS, Clemens TL, Parrish JA, Holick MF (1982) Vitamin-D synthesis and metabolism after ultraviolet irradiation of normal and vitamin-D-deficient subjects. N Engl J Med 306:722–725PubMed
5.
Mohr SB, Garland CF, Gorham ED, Grant WB, Garland FC (2007) Is ultraviolet B irradiance inversely associated with incidence rates of endometrial cancer: an ecological study of 107 countries. Prev Med 45:327–331PubMedCrossRef
6.
Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM (2001) Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 358:1500–1503PubMedCrossRef
7.
EURODIAB Substudy 2 Study Group (1999) Vitamin D supplement in early childhood and risk for Type I (insulin-dependent) diabetes mellitus. Diabetologia 42:51–54CrossRef
8.
Stene LC, Joner G (2003) Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case-control study. Am J Clin Nutr 78:1128–1134PubMed
9.
Dahlquist GG, Patterson C, Soltesz G (1999) Perinatal risk factors for childhood type 1 diabetes in Europe. The EURODIAB Substudy 2 Study Group. Diabetes Care 22:1698–1702PubMedCrossRef
10.
Stene LC, Barriga K, Norris JM et al (2004) Perinatal factors and development of islet autoimmunity in early childhood: the diabetes autoimmunity study in the young. Am J Epidemiol 160:3–10PubMedCrossRef
11.
Fronczak CM, Baron AE, Chase HP et al (2003) In utero dietary exposures and risk of islet autoimmunity in children. Diabetes Care 26:3237–3242PubMedCrossRef
12.
Stene LC, Ulriksen E, Magnus P, Joner G (2000) Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring. Diabetologia 43:1093–1098PubMedCrossRef
13.
Staples JA, Ponsonby AL, Lim LL, McMichael AJ (2003) Ecologic analysis of some immune-related disorders, including type 1 diabetes, in Australia: latitude, regional ultraviolet radiation, and disease prevalence. Environ Health Perspect 111:518–523PubMed
14.
Ponsonby AL, Lucas RM, van der Mei IA (2005) UVR, vitamin D and three autoimmune diseases–multiple sclerosis, type 1 diabetes, rheumatoid arthritis. Photochem Photobiol 81:1267–1275PubMedCrossRef
15.
Akerblom HK, Reunanen A (1985) The epidemiology of insulin-dependent diabetes mellitus (IDDM) in Finland and in northern Europe. Diabetes Care 8:10–16PubMed
16.
Burgaz A, Akesson A, Oster A, Michaelsson K, Wolk A (2007) Associations of diet, supplement use, and ultraviolet B radiation exposure with vitamin D status in Swedish women during winter. Am J Clin Nutr 86:1399–1404PubMed
17.
Brustad M, Edvardsen K, Wilsgaard T, Engelsen O, Aksnes L, Lund E (2007) Seasonality of UV-radiation and vitamin D status at 69 degrees north. Photochem Photobiol Sci 6:903–908PubMedCrossRef
18.
Brustad M, Alsaker E, Engelsen O, Aksnes L, Lund E (2004) Vitamin D status of middle-aged women at 65–71 degrees N in relation to dietary intake and exposure to ultraviolet radiation. Public Health Nutr 7:327–335PubMed
19.
Kokkonen J, Koivisto M, Kirkinen P (1983) Seasonal variation in serum-25-OH-D3 in mothers and newborn infants in northern Finland. Acta Paediatr Scand 72:93–96PubMedCrossRef
20.
Nystrom L, Dahlquist G, Ostman J et al (1992) Risk of developing insulin-dependent diabetes mellitus (IDDM) before 35 years of age: indications of climatological determinants for age at onset. Int J Epidemiol 21:352–358PubMedCrossRef
21.
Adorini L (2002) Immunomodulatory effects of vitamin D receptor ligands in autoimmune diseases. Int Immunopharmacol 2:1017–1028PubMedCrossRef
22.
Kent SC, Chen Y, Bregoli L et al (2005) Expanded T cells from pancreatic lymph nodes of type 1 diabetic subjects recognize an insulin epitope. Nature 435:224–228PubMedCrossRef
23.
Penna G, Amuchastegui S, Giarratana N et al (2007) 1,25-Dihydroxyvitamin D3 selectively modulates tolerogenic properties in myeloid but not plasmacytoid dendritic cells. J Immunol 178:145–153PubMed
24.
Griffin MD, Dong X, Kumar R (2007) Vitamin D receptor-mediated suppression of Re1B in antigen presenting cells: a paradigm for ligand-augmented negative transcriptional regulation. Arch Biochem Biophys 460:218–226PubMedCrossRef
25.
Adorini L, Giarratana N, Penna G (2004) Pharmacological induction of tolerogenic dendritic cells and regulatory T cells. Semin Immunol 16:127–134PubMedCrossRef
26.
Chailurkit LO, Rajatanavin R, Teerarungsikul K, Ongphiphadhanakul B, Puavilai G (1996) Serum vitamin D, parathyroid hormone and biochemical markers of bone turnover in normal Thai subjects. J Med Assoc Thai 79:499–504PubMed
27.
Haddad JG, Chyu KJ (1971) Competitive protein-binding radioassay for 25-hydroxycholecalciferol. J Clin Endocrinol Metab 33:992–995PubMedCrossRef
28.
National Academy of Sciences–Institute of Medicine–Food and Nutrition Board–Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (1997) Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. National Academy Press, Washington DC
29.
Chen TC, Chimeh F, Lu Z et al (2007) Factors that influence the cutaneous synthesis and dietary sources of vitamin D. Arch Biochem Biophys 460:213–217PubMedCrossRef
30.
Vieth R (1999) Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 69:842–856PubMed
31.
Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67:373–378PubMed
32.
Hathcock JN, Shao A, Vieth R, Heaney R (2007) Risk assessment for vitamin D. Am J Clin Nutr 85:6–18PubMed
33.
34.
Berwick M, Armstrong BK, Ben-Porat L et al (2005) Sun exposure and mortality from melanoma. J Natl Cancer Inst 97:195–199PubMedCrossRef
35.
36.
Menon RK, Sperling MA (2003) Pediatric diabetes. Kluwer, Boston, MA
37.
Chaturvedi N, Stephenson JM, Fuller JH (1996) The relationship between socioeconomic status and diabetes control and complications in the EURODIAB IDDM Complications Study. Diabetes Care 19:423–430PubMedCrossRef
38.
Rothman KS (1998) Modern epidemiology. Lippincott-Raven, Philadelphia, PA
39.
Romanescu G, Pleceas M (1968) Inactivating action of ultraviolet rays on influenza virus and Coxsackie virus. Stud Cercet Inframicrobiol 19:105–112 (in Romanian)PubMed
40.
Barrett-Connor E (1985) Is insulin-dependent diabetes mellitus caused by Coxsackie virus B infection? A review of the epidemiologic evidence. Rev Infect Dis 7:207–215PubMed
41.
Riley RL (1977) Ultraviolet air disinfection for protection against influenza. Johns Hopkins Med J 141:29–30PubMed
42.
43.
Suminski RR, Poston WC, Market P, Hyder M, Sara PA (2008) Meteorological conditions are associated with physical activities performed in open-air settings. Int J Biometeorol 52:189–197PubMedCrossRef
44.
Molla AM, Al Badawi M, Hammoud MS et al (2005) Vitamin D status of mothers and their neonates in Kuwait. Pediatr Int 47:649–652PubMedCrossRef
45.
Mathieu C, Waer M, Laureys J, Rutgeerts O, Bouillon R (1994) Prevention of autoimmune diabetes in NOD mice by 1,25 dihydroxyvitamin D3. Diabetologia 37:552–558PubMedCrossRef
46.
Zella JB, McCary LC, DeLuca HF (2003) Oral administration of 1,25-dihydroxyvitamin D3 completely protects NOD mice from insulin-dependent diabetes mellitus. Arch Biochem Biophys 417:77–80PubMedCrossRef
47.
48.
World Health Organization (2001) The World Health Report 2001 statistical annex. WHO publication no. 1242001. WHO, Geneva, p 160 [Table 5. Selected national health accounts indicators for all member states, estimates for 1997 and 1998]. Available from http://​www.​who.​int/​whr/​2001/​en/​annex5_​en.​pdf, accessed 11 May 2008
Metadata
Title
The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide
Authors
S. B. Mohr
C. F. Garland
E. D. Gorham
F. C. Garland
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 8/2008
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-008-1061-5

Other articles of this Issue 8/2008

Diabetologia 8/2008 Go to the issue

Article

Diabetes mellitus among young adults in Sri Lanka—role of GAD antibodies in classification and treatment: The Sri Lanka Young Diabetes study

Article

An RBP4 promoter polymorphism increases risk of type 2 diabetes

Article

Fuel metabolism during exercise in euglycaemia and hyperglycaemia in patients with type 1 diabetes mellitus—a prospective single-blinded randomised crossover trial

Article

The effect of birthweight upon insulin resistance and associated cardiovascular risk factors in adolescence is not explained by fetal growth velocity in the third trimester as measured by repeated ultrasound fetometry

Short Communication

Autoantibodies to islet antigen-2 are associated with HLA-DRB1*07 and DRB1*09 haplotypes as well as DRB1*04 at onset of type 1 diabetes: the possible role of HLA-DQA in autoimmunity to IA-2

Letter

Integrity of cerebral white matter in type 1 diabetes
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits