الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Type 1 DM remains a serious costly and rising world wide health problem resulting substantial morbidity and mortality Over the last two decades the incidence of type 1 DM has increased steadily world. It is growing by 3% per year in children and adolescents and at an alarming 5% per year among per-school children (Dabelea et al., 2007).Type 1 DM is considered to be auto immune disease in which the insulin producing β cells are destroyed in genetically predisposed individuals (Atkinson and Eisenbarth,2001).Both genetic and environmental factors are though to play arole in the selective destruction of the insulin- producing β-cell in TiDM. Because the peak incidence occurs in late childhood, researchers have could play an important role ( soltesz, 2003). The study was designated to identify the risk factors e.g. maternal age at delivery, birth order, duration of breast feeding, early infant feeding and cow milk exposure and gestational age that are associated with occurrence of T1DM in children (up to18) years. The sample included 75 children with T1DM (up to 18 years)of both sexes managed in the diabetic pediatric out patient clinic of zagazig university hospital in sharkia governorate, and 75 normal healthy children matching the same age and sex as control group, all the studied children were subjected to structured interview questionnaire to each one and (his /her) accompanying mother (includes socio-demographic characteristics of mothers , socio-demographic characteristics of the studied child, maternal history, child history, nutritional history and family history of DM. The results of the study showed that there was no significant difference between study and control group regarding all socio –demographic characteristics including age of the mother, educational level and employment status of the mothers, age and sex of the children and their educational level, the mean duration of the disease (2.8± 2.4) years. NPH insulin is the most commonly used type of insulin among studied diabetic children .Also it was reported by many of the diabetic children and their mothers that there is inexpensive and easy transport methods for the diabetes clinic.No significant difference between study and control group regarding receiving medication during pregnancy and mode of delivery. The same was found regarding number of family members and monthly family income per capita.In this study there was a significant increase in the incidence of T1DM which could be explained by increasing maternal age, Short duration of breast feeding and early infant feeding and cow milk exposure. Gestational age at time of delivery has no significant effect on the incidence of T1DM.