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Phototherapy Risk: Type 1 Diabetes? :

October 20, 2016

If you are a regular reader of the journal, you will note that we have published several articles in the recent past regarding whether phototherapy increases the risk for a variety of disorders ranging from pediatric cancer (REF—June 2016) to autism.


If you are a regular reader of the journal, you will note that we have published several articles in the recent past regarding whether phototherapy increases the risk for a variety of disorders ranging from pediatric cancer (10.1542/peds.2015-1353—June 2016) to autism. Fortunately these studies show that the absolute risk even if an association is statistically shown to be positive is small or negative for these disorders but studies continue to look for adverse effects of this standard treatment for infant jaundice.


This month, the spotlight is on phototherapy and whether it may be increasing the risk of type 1 diabetes according to a retrospective cohort study by Newman et al. (10.1542/peds.2016-0687). Again similar to some of Dr. Newman’s other studies of phototherapy potential risks, this study involves big data ---meaning it summarizes data on almost 500,000 children born at >= 35 weeks in 15 California hospitals that are part of the Kaiser Permanente System.

The investigators linked those babies in their data base who had and had not had phototherapy with whether they developed diabetes controlling for other potential confounders.  The good news is no increased incidence of diabetes is noted but rather than take our word for that, please read the study and appreciate the thoroughness of the analysis that strongly demonstrates no association between diabetes and phototherapy.  Even though this is a negative study, it still reminds us to be judicious and follow AAP guidelines rather than simply “light up” mildly jaundiced infants because the phototherapy lights are readily available to use.  

We may not fully understand just what the ultraviolet light may be doing as it breaks down bilirubin to an infant’s body in terms of adverse consequences of this therapy—but at least for now, the benefits of phototherapy when used appropriately far outweighs any risks thus far reported.  Hopefully you agree—and will continue to appreciate the role phototherapy can play in those infants whose rising bilirubins relative to their gestational age or birthweight require this treatment to prevent the possibility of kernicterus. 

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