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CompletedNCT02929953T1DpremiesUpdated Aug 13, 2019

Prematurity Prevalence Among T1D Patients and Its Characteristics Compared With Premature-born Non-diabetic Patients

An observational study in Type 1 Diabetes Mellitus, sponsored by Assaf Harofeh MC. Completed at 1 site in Israel. Open to participants aged 1 Year to 25 Years. Per ClinicalTrials.gov, last updated 2019-08-13.

Sponsored by Assaf Harofeh MC · Observational

Study type
Observational
Model
Cohort
Time perspective
Cross-sectional
Enrollment
3,600
Ages
1 Year to 25 Years
Sex
All
01

Study summary

The aims of this study are:

  1. To assess the prevalence of prematurity, especially early prematurity, among T1D patients, and compare it to the prematurity prevalence among the non-diabetic general population in Israel.
  2. To characterize epidemiological and clinical factors that differ between premature-born patients that developed T1D and those that have not, including the nutritional and therapeutic properties in NICU.
Read the detailed description

A national cohort study, including linkage of data from 13 pediatric diabetes centers and Israeli National Registries, including all patients with T1D born during 1990-2013. Data collected includes: ethnicity, gestational age, birth season, age and season at T1DM diagnosis, and presence of autoimmunity in family. The prevalence of prematurity among T1D is compared to the non-diabetic general population registry of 2000-2013. Additional comparisons are between T1D patients born term and preterm, aimed to unveil specific influencing clinical and epidemiological factors.

In the latter part of the study, a multi-centered, paired case-control study is performed.

Preterm born T1D patients will be paired to matched non-diabetic children at a ratio of 3:1, according to medical center, sex, gestational week of birth, season and year of birth. Data collected includes: ethnicity, family history of autoimmune diseases, age and type of first enteral nutrition, and pharmacological exposures.

02

Conditions studied

  • Type 1 Diabetes Mellitus

Keywords

  • premature birth
  • risk factor
  • type 1 diabetes mellitus
  • seasonality
  • prevalence
  • enteral feeding
  • immunomodulating medications
  • early onset
03

In context

Diabetes Mellitus, Type 1

3,614 studies on the registry are indexed under Diabetes Mellitus, Type 1; 586 are open to participants now.

This study's planned enrollment of 3,600 is above the median of 121 across 769 observational studies indexed under Diabetes Mellitus, Type 1.

Browse Diabetes Mellitus, Type 1 studies →

Lead sponsor

Assaf Harofeh MC is the lead sponsor of 8 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
1 Year to 25 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

All T1D patients in Israel, born during 1990-2013 and diagnosed prior to January 2015, time of data collection. Inclusion criteria included all patients diagnosed as T1D by a pediatric endocrinologist according to the American Diabetes Association criteria, and treated for their T1D with insulin. Patients are identified from registries of the 13 participating centers.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Patients diagnosed with T1D
  2. Patients treated in one of the 13 participating centers
  3. For the case-control portion of the study, all children born between 1.1.1990-31.12.2013 and admitted to NICU medical centers that have been included in the original cohort portion
  4. Patients for whom a complete medical record is available

Exclusion criteria

Exclusion Criteria:

  1. Lack of birth data
  2. Unknown type of diabetes
  3. For case control portion, an incomplete medical record/inadequate documentation
05

Study design

Observational model
Cohort
Time perspective
Cross-sectional
Enrollment
3,600 participants (estimated)
Patient registry
No

Groups and cohorts

  • Diabetes mellitus type 1

    all T1DM patients in Israel, born during 2000-2013 and diagnosed prior to January 2015. chart review

    Other: chart review

  • Non-diabetic

    non-diabetic general population born in Israel during 2000-2013, according to the Israeli Health Ministry's Birth Registry (IHMBR) chart review

    Other: chart review

Interventions

  • Otherchart review

    data from charts and from registries will be compared

06

What researchers measure

Primary outcomes

  1. prematurity prevalence among T1D patients

    the number of premature born among those with type 1 diaetes compared to prematurity in health non diabetic population

    Time frame: 1 years

Secondary outcomes

  1. food exposure of premature who developed T1DM compared with prematures who did not develop diabetes

    75 files of premies with T1DM will be ccompared to 225 charts of premies, non diabetic for age of food initiation

    Time frame: 1 years

  2. Medications exposure in premature who developed T1DM compared with prematures who did not develop diabetes

    75 files of premies with T1DM will be ccompared to 225 charts of premies, non diabetic for age and type of drugs initiation

    Time frame: 1 years

07

Study locations

1 site
  • Assaf Harofeh Medical Center
    Ẕerifin, 70300, Israel
08

References and documents

Publications

  • Blumenfeld O, Dichtiar R, Shohat T; Israel IDDM Registry Study Group (IIRSG). Trends in the incidence of type 1 diabetes among Jews and Arabs in Israel. Pediatr Diabetes. 2014 Sep;15(6):422-7. doi: 10.1111/pedi.12101. Epub 2013 Nov 27. PubMed 24283719 ↗
  • Egro FM. Why is type 1 diabetes increasing? J Mol Endocrinol. 2013 Jul 12;51(1):R1-13. doi: 10.1530/JME-13-0067. Print 2013. PubMed 23733895 ↗
  • De Curtis M, Rigo J. The nutrition of preterm infants. Early Hum Dev. 2012 Mar;88 Suppl 1:S5-7. doi: 10.1016/j.earlhumdev.2011.12.020. Epub 2012 Jan 17. PubMed 22261289 ↗
  • Working Group Of Pediatrics Chinese Society Of Parenteral And Enteral Nutrition, Working Group Of Neonatology Chinese Society Of Pediatrics, Working Group Of Neonatal Surgery Chinese Society Of Pediatric Surgery. CSPEN guidelines for nutrition support in neonates. Asia Pac J Clin Nutr. 2013;22(4):655-63. doi: 10.6133/apjcn.2013.22.4.21. PubMed 24231027 ↗
  • Kagohashi Y, Otani H. Role of nutritional factors at the early life stages in the pathogenesis and clinical course of type 1 diabetes. Biomed Res Int. 2015;2015:382165. doi: 10.1155/2015/382165. Epub 2015 Mar 26. PubMed 25883958 ↗
  • Ziegler AG, Pflueger M, Winkler C, Achenbach P, Akolkar B, Krischer JP, Bonifacio E. Accelerated progression from islet autoimmunity to diabetes is causing the escalating incidence of type 1 diabetes in young children. J Autoimmun. 2011 Aug;37(1):3-7. doi: 10.1016/j.jaut.2011.02.004. Epub 2011 Mar 3. PubMed 21376535 ↗
  • Jaberi-Douraki M, Liu SW, Pietropaolo M, Khadra A. Autoimmune responses in T1DM: quantitative methods to understand onset, progression, and prevention of disease. Pediatr Diabetes. 2014 May;15(3):162-74. doi: 10.1111/pedi.12148. PubMed 24827702 ↗
  • Walker WA. Initial intestinal colonization in the human infant and immune homeostasis. Ann Nutr Metab. 2013;63 Suppl 2:8-15. doi: 10.1159/000354907. Epub 2013 Nov 8. PubMed 24217032 ↗
  • Kemppainen KM, Ardissone AN, Davis-Richardson AG, Fagen JR, Gano KA, Leon-Novelo LG, Vehik K, Casella G, Simell O, Ziegler AG, Rewers MJ, Lernmark A, Hagopian W, She JX, Krischer JP, Akolkar B, Schatz DA, Atkinson MA, Triplett EW; TEDDY Study Group. Early childhood gut microbiomes show strong geographic differences among subjects at high risk for type 1 diabetes. Diabetes Care. 2015 Feb;38(2):329-32. doi: 10.2337/dc14-0850. Epub 2014 Dec 17. PubMed 25519450 ↗
  • Kostic AD, Gevers D, Siljander H, Vatanen T, Hyotylainen T, Hamalainen AM, Peet A, Tillmann V, Poho P, Mattila I, Lahdesmaki H, Franzosa EA, Vaarala O, de Goffau M, Harmsen H, Ilonen J, Virtanen SM, Clish CB, Oresic M, Huttenhower C, Knip M; DIABIMMUNE Study Group; Xavier RJ. The dynamics of the human infant gut microbiome in development and in progression toward type 1 diabetes. Cell Host Microbe. 2015 Feb 11;17(2):260-73. doi: 10.1016/j.chom.2015.01.001. Epub 2015 Feb 5. PubMed 25662751 ↗
  • Zeitlin J, Szamotulska K, Drewniak N, Mohangoo AD, Chalmers J, Sakkeus L, Irgens L, Gatt M, Gissler M, Blondel B; Euro-Peristat Preterm Study Group. Preterm birth time trends in Europe: a study of 19 countries. BJOG. 2013 Oct;120(11):1356-65. doi: 10.1111/1471-0528.12281. Epub 2013 May 24. PubMed 23700966 ↗
  • Soll RF, Edwards WH. Antibiotic use in neonatal intensive care. Pediatrics. 2015 May;135(5):928-9. doi: 10.1542/peds.2015-0707. No abstract available. PubMed 25896842 ↗
  • Li S, Zhang M, Tian H, Liu Z, Yin X, Xi B. Preterm birth and risk of type 1 and type 2 diabetes: systematic review and meta-analysis. Obes Rev. 2014 Oct;15(10):804-11. doi: 10.1111/obr.12214. Epub 2014 Jul 30. PubMed 25073871 ↗
  • Cardwell CR, Carson DJ, Patterson CC. Parental age at delivery, birth order, birth weight and gestational age are associated with the risk of childhood Type 1 diabetes: a UK regional retrospective cohort study. Diabet Med. 2005 Feb;22(2):200-6. doi: 10.1111/j.1464-5491.2005.01369.x. PubMed 15660739 ↗
  • Crump C, Winkleby MA, Sundquist K, Sundquist J. Risk of diabetes among young adults born preterm in Sweden. Diabetes Care. 2011 May;34(5):1109-13. doi: 10.2337/dc10-2108. Epub 2011 Mar 16. PubMed 21411504 ↗
  • Algert CS, McElduff A, Morris JM, Roberts CL. Perinatal risk factors for early onset of Type 1 diabetes in a 2000-2005 birth cohort. Diabet Med. 2009 Dec;26(12):1193-7. doi: 10.1111/j.1464-5491.2009.02878.x. PubMed 20002469 ↗
  • Capasso L, Borrelli A, Cerullo J, Pisanti R, Figliuolo C, Izzo F, Paccone M, Ferrara T, Lama S, Raimondi F. Role of immunoglobulins in neonatal sepsis. Transl Med UniSa. 2014 Dec 19;11:28-33. eCollection 2015 Jan-Apr. PubMed 25674546 ↗
  • Gritz EC, Bhandari V. The human neonatal gut microbiome: a brief review. Front Pediatr. 2015 Mar 5;3:17. doi: 10.3389/fped.2015.00017. eCollection 2015. PubMed 25798435 ↗
  • Arboleya S, Sanchez B, Milani C, Duranti S, Solis G, Fernandez N, de los Reyes-Gavilan CG, Ventura M, Margolles A, Gueimonde M. Intestinal microbiota development in preterm neonates and effect of perinatal antibiotics. J Pediatr. 2015 Mar;166(3):538-44. doi: 10.1016/j.jpeds.2014.09.041. Epub 2014 Oct 25. PubMed 25444008 ↗
  • Modi SR, Collins JJ, Relman DA. Antibiotics and the gut microbiota. J Clin Invest. 2014 Oct;124(10):4212-8. doi: 10.1172/JCI72333. Epub 2014 Oct 1. PubMed 25271726 ↗
  • Uusitalo U, Liu X, Yang J, Aronsson CA, Hummel S, Butterworth M, Lernmark A, Rewers M, Hagopian W, She JX, Simell O, Toppari J, Ziegler AG, Akolkar B, Krischer J, Norris JM, Virtanen SM; TEDDY Study Group. Association of Early Exposure of Probiotics and Islet Autoimmunity in the TEDDY Study. JAMA Pediatr. 2016 Jan;170(1):20-8. doi: 10.1001/jamapediatrics.2015.2757. PubMed 26552054 ↗
  • Adar A, Shalitin S, Eyal O, Loewenthal N, Pinhas-Hamiel O, Levy M, Dally-Gottfried O, Landau Z, Zung A, Levy-Khademi F, Zangen D, Tenenbaum-Rakover Y, Rachmiel M. Prevalence of early and late prematurity is similar among pediatric type 1 diabetes patients and the general population. Diabetes Metab Res Rev. 2018 Jul;34(5):e2996. doi: 10.1002/dmrr.2996. Epub 2018 Mar 24. PubMed 29471580 ↗

Individual participant data

Plan to share: No — IPD data will not be available for anyone other than the PI and co-investigators.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 13, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02929953
Lead sponsor
Assaf Harofeh MC
Collaborators
Shaare Zedek Medical Center, Wolfson Medical Center, Ziv Medical Center, Schneider Children's Medical Center, Israel, Tel-Aviv Sourasky Medical Center, Maccabi Healthcare Services, Israel, Kaplan Medical Center, HaEmek Medical Center, Israel, Soroka University Medical Center, Rambam Health Care Campus, Hadassah Medical Organization
Responsible party
Assaf Harofeh MC (Assaf-Harofeh Medical Center, Assaf-Harofeh Medical Center) — Sponsor-investigator
First posted
Oct 11, 2016
Start date
Jan 2014
Primary completion
Apr 2019
Completion
Apr 2019
Last update
Aug 13, 2019

Study contacts

marianna Rachmiel, md
principal investigator · Assaf Haroffeh Medical Center

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2019. You cannot join it, but the record below documents what was studied.

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