Diabetes in the young – a global view and worldwide estimates of numbers of children with type 1 diabetes

Abstract

This paper describes the methodology, results and limitations of the 2013 International Diabetes Federation (IDF) Atlas (6th edition) estimates of the worldwide numbers of prevalent cases of type 1 diabetes in children (<15 years). The majority of relevant information in the published literature is in the form of incidence rates derived from registers of newly diagnosed cases. Studies were graded on quality criteria and, if no information was available in the published literature, extrapolation was used to assign a country the rate from an adjacent country with similar characteristics. Prevalence rates were then derived from these incidence rates and applied to United Nations 2012 Revision population estimates for 2013 for each country to obtain estimates of the number of prevalent cases. Data availability was highest for the countries in Europe (76%) and lowest for the countries in sub-Saharan Africa (8%). The prevalence estimates indicate that there are almost 500,000 children aged under 15 years with type 1 diabetes worldwide, the largest numbers being in Europe (129,000) and North America (108,700). Countries with the highest estimated numbers of new cases annually were the United States (13,000), India (10,900) and Brazil (5000). Compared with the prevalence estimates made in previous editions of the IDF Diabetes Atlas, the numbers have increased in most of the IDF Regions, often reflecting the incidence rate increases that have been well-documented in many countries. Monogenic diabetes is increasingly being recognised among those with clinical features of type 1 or type 2 diabetes as genetic studies become available, but population-based data on incidence and prevalence show wide variation due to lack of standardisation in the studies. Similarly, studies on type 2 diabetes in childhood suggest increased incidence and prevalence in many countries, especially in Indigenous peoples and ethnic minorities, but detailed population-based studies remain limited.

All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973–2013

“…A recent publication from Japan confirms that relative mortality remains high (SMR 10.7) at 35 years of follow-up [10]. Along with Finland and Sweden, Norway has one of the highest incidences of childhood-onset type 1 diabetes in the world [11]. SMR was 3.6 in a recent Finnish study assessing mortality in a nationwide, populationbased cohort of childhood-onset (<15 years) diabetes covering the period 1970-2007 [4].…”

Experience of a serious life event increases the risk for childhood type 1 diabetes: the ABIS population-based prospective cohort study

“…It is usually preceded by autoimmune destruction of insulin-producing beta cells in genetically predisposed individuals [1], and several environmental factors such as viral infections [2], dietary habits in infancy [3], birthweight and early weight gain [4], as well as chronic stress [5], have been proposed as risk factors. The incidence among young children is increasing in most countries in the world [6], suggesting that environmental factors need to be examined seriously.…”

Risk of epilepsy in type 1 diabetes mellitus: a population-based cohort study

“…Introduction Type 1 diabetes mellitus is one of the most common autoimmune disorders in children, with a 3% annual increase in the global incidence rate since the 1980s [1][2][3]. In recent decades, the incidence of type 1 diabetes has increased in children and adolescents, particularly those aged younger than 5 years [4].…”