Occupation with grain crops is associated with lower type 1 diabetes incidence: Registry-based case-control study

PLoS One. 2017 Jul 11;12(7):e0181143. doi: 10.1371/journal.pone.0181143. eCollection 2017.


Intranasal administration of gliadin prevents autoimmune diabetes in non-obese diabetic mice. The current study was designed to investigate if bakers are intranasally exposed to gluten during work and whether occupation as baker is inversely associated with type 1 diabetes. Gliadin was measured in nasal swabs from eight bakers and butchers. The odds ratio of type 1 diabetes in selected profession groups was analysed in a registry-based case-control study with data from 1980 to 2010 derived from Statistics Denmark. The cohort included 1,210,017 Danish individuals, thereof 15,451 with type 1 diabetes (1.28%). Average nasal gliadin swab content after full working days was 6.3 μg (confidence interval (CI): 2.8 to 9.7) among bakers, while no nasal gliadin was detected among butchers. The odds ratio of type 1 diabetes was lower among bakers (OR = 0.57; CI: 0.52 to 0.62) and agriculture workers occupied with production of grains (OR = 0.65; CI: 0.56 to 0.75). Bakers had a lower odds ratio of type 1 diabetes, which potentially could be attributed to exposure of nasal mucosal gluten during work, as observed in this study. If other studies confirm the present observations, intranasal gliadin administration could possibly be an easy and safe approach for the prevention of type 1 diabetes in high-risk individuals or prediabetic subjects.

MeSH terms

  • Case-Control Studies
  • Crops, Agricultural
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Edible Grain / chemistry*
  • Gliadin / analysis*
  • Glutens
  • Humans
  • Nasal Mucosa / metabolism
  • Occupations
  • Odds Ratio


  • Glutens
  • Gliadin

Grant support

This study was supported by Kirsten and Freddy Johannsen Foundation. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.