Diabetes and Drinking Water

By Freeman, Kris | Environmental Health Perspectives, May 2000 | Go to article overview

Diabetes and Drinking Water


Freeman, Kris, Environmental Health Perspectives


Exploring the Connection to Nitrate

Several recent studies have correlated nitrate in drinking water with the incidence of type 1 diabetes mellitus. Given a sharp increase in type 1 diabetes in the Netherlands, Jan M. S. van Maanen and colleagues attemped to clarify the possible nitrate-diabetes relationship. Their results show no convincing evidence that nitrate in drinking water at concentrations of 25 milligrams per liter (mg/L) or less is a risk factor for the disease, although a link at higher concentrations cannot be excluded [EHP 108:461-465].

The human body transforms nitrate to nitrite. Nitrite may also react with amines in the digestive juices to form N-nitroso compounds. N-nitroso compounds have been shown to attack pancreatic cells in animals, causing diabetes. Studies in the United Kingdom and United States have linked nitrate in water to type 1 diabetes, while studies in Sweden and Finland have shown a dose-response relationship between type 1 diabetes and foods rich in nitrate, nitrite, and nitrosamines.

In the Netherlands the incidence of type 1 diabetes among children 0-4 years old doubled between 1990 and 1995, and the overall incidence in children aged 0-14 years increased 32% between 1980 and 1995, from 11.1 to 14.6 cases per 100,000. Nitrate concentrations in drinking water are tracked in every postal code in the Netherlands. In their ecological and epidemiological study, the authors sorted by postal code the cases of 1,064 children aged 0-14 years who had been diagnosed with type 1 diabetes between 1993 and 1995. …

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