I did not nurse my son, and he developed type 1 diabetes at the age of two and one-half. He has a baby sister I am nursing her for a year and to whom I am not giving any milk products. I am wondering what to do after the first year. Could I give soy milk instead of cow’s milk? Does it make a difference after the age of one? Also, I have read articles that wheat protein might be a possible trigger. Should I avoid that as well?

As you must already know, type 1A (autoimmune) diabetes is the product of both a genetic predisposition and one or more presently undefined environmental factors. The Finns who have a very high incidence of this form of diabetes were the first to propose a link to early exposure to cow’s milk, and later work in New Zealand made a case that the link was to a special form of casein. However the studies promoting this theme have been equally balanced by those disclaiming it and a very large study in North America called DAISY has so far shown no such association.

Your little daughter has only about a 5% chance of developing type 1A diabetes anyway so I think it would be safe to introduce cow’s milk at this stage and of course soy formula would be fine too. The possibility that early exposure to wheat protein may not only affect the onset of celiac disease (a linked autoimmune disorder), but also the incidence of diabetes is being actively studied. The evidence to date is that a gluten free diet does not affect the incidence of diabetes besides which adopting a gluten free diet is not a step to be undertaken lightly. See Hummel M, Bonifacio E, Naserke HE, Ziegler AG. Elimination of dietary gluten does not reduce titers of type 1 diabetes-associated autoantibodies in high-risk subjects. Diabetes Care 2002 Jul;25(7):1111-6.

DOB