Incidence and time trends of type 2 diabetes mellitus in youth aged 5–19 years: a population-based registry in Zhejiang, China, 2007 to 2013

Abstract

BackgroundThe incidence of type 2 diabetes mellitus (T2DM) has been increasing globally over the past two decades in children and adolescents. There are currently a dearth of comprehensive population-based estimates of T2DM incidence and time trends in Chinese youth.MethodsA population-based diabetes registry system in 30 representative districts in Zhejiang has been established for diabetes surveillance. All newly cases diagnosed by physicians in local hospitals and wards were registered using the registry system through web services and direct network report. The data were primarily abstracted from medical records in hospitals and wards. Annual incidence rates and their 95% confidence intervals (CIs) by age groups and sex were calculated per 100 000 person-years. Poisson regression models were applied to assess the effects of diagnosis year, age groups, sex and residence area on T2DM incidence and to examine the average annual percentage change in incidence.ResultsThere were 392 newly diagnosed cases of T2DM (210 boys and 182 girls) over the study period. The mean annual age-standardized incidence was 1.96/100 000 person-years (95% CIs: 1.85–2.08). No statistically significant difference in incidence was found between boys and girls. However, the risk for T2DM was 1.49 times higher in urban area than in rural area. Besides, the mean annual incidence in youth increased with age. The age-standardized incidence was about 5 times higher in 2013 than in 2007. Steep rising incidence was observed, with an average annual increase of 26.6% in youth aged 10–19 years.ConclusionsThe incidence of T2DM in children and adolescents was low in Zhejiang relative to other countries, whereas it increased markedly over the study period. Preventive strategies for T2DM are necessary in pediatric population.

Increasing incidence of type 2 diabetes in New Zealand children <15 years of age in a regional‐based diabetes service, Auckland, New Zealand

“…On balance this raises the possibility that part of the lack of change may be related to a lack of awareness of the symptoms of diabetes in the community. Interestingly, girls were more likely to have T2DM, consistent with previous studies, but were also less likely to present with symptoms. This may indicate greater self‐awareness in adolescent girls than boys.…”

“…[1][2][3] There are low incidences in European countries, increasing incidence in Asian countries and a highly persistent incidence in Native American Indians and indigenous people of Canada and Australia. [4][5][6][7][8][9] Historically, cases of T2DM in children were rare and the first cases were reported in Australia, for example, only in the 1990s. [10][11][12] Recent studies from China, Japan and Western Australia suggest that the risk of T2DM in children and adolescents continues to increase.…”

“…The onset of type 2 diabetes mellitus (T2DM) in late childhood and in adolescence is increasingly recognised in paediatric populations around the world . There are low incidences in European countries, increasing incidence in Asian countries and a highly persistent incidence in Native American Indians and indigenous people of Canada and Australia . Historically, cases of T2DM in children were rare and the first cases were reported in Australia, for example, only in the 1990s .…”

“…Historically, cases of T2DM in children were rare and the first cases were reported in Australia, for example, only in the 1990s . Recent studies from China, Japan and Western Australia suggest that the risk of T2DM in children and adolescents continues to increase . For example, in China, the age‐standardised incidence increased approximately fivefold from 2007 to 2013 .…”

Secular trends in incidence of type 1 and type 2 diabetes in Hong Kong: A retrospective cohort study

“…Furthermore, the increase was larger in Asians and Pacific Islanders (annual increase 16.0%) than Europeans (annual increase 3.3%). Similarly, Wu and colleagues reported an increase in incidence from 0.7 to 3.6 per 100,000 person-years using a registry of 392 newly diagnosed cases of young-onset diabetes presented between 2007 and 2013 in Zhejiang, China [19]. Among those aged <20 years in Hong Kong, the average annual increase in incidence was 4.8%-5.9%, and the last recorded crude incidence rates in 2015 were 8.3 and 9.2 per 100,000 person-years in boys and girl, respectively, which were lower than the US figures but higher than rates in China.…”