Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURODIAB ACE study

Low frequency of HLA DRB1*03 – DQB1*02 and DQB1*0302 haplotypes in Romania is consistent with the country's low incidence of Type I diabetes

“…The mean age at the onset of disease was 12.1 6.7 years. In most patients the onset of diabetes was before 17 years of age (166; 78.3 %) and the vast majority (149 out of 212; 70.3 %) had the onset before 14 years of age, consistent with the EURODIAB selection criteria [2]. Some of the subjects were therefore included in the EURODIAB epidemiological study between 1988±1997.…”

“…Paulescuº Institute outpatient department and in the diabetes centres of the other 12 Romanian districts. The selection of diabetic subjects was made according to the guidelines of EURODIAB epidemiological study protocol, that is those cases that had an abrupt onset with diabetic ketoacidosis or required insulin treatment with first insulin dose within the first month from diagnosis were diagnosed as having Type I diabetes [2]. Families were selected if both parents were alive and willing to participate in the study.…”

“…Using a family study approach, we typed 204 Romanian Type I diabetic families by employing a single-protocol method of genotyping for multiple HLA and non-HLA polymorphisms under identical conditions, with the SSP-PCR technique [25,26,27]. To compare results, we used data from another group of families with Type I diabetes from Sardinia [28], a ªhot spotº in incidence on the European map [1,2].…”

The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children

“…The 95% CI were estimated using an approximated Poisson distribution as described previously [30]. Incidence data from 1996 and 1997 in children of 0 to 14 years of age were provided by EURODIAB TIGER, details of which have been previously published [4,6].…”

“…Studies of the epidemiology of Type 1 diabetes in different populations can provide important clues about putative environmental risk factors. The incidence of the disease in children up to 15 years of age is well documented by two multi-centre studies [4,5,6,7], with incidence varying from less than 1 per 100000 person years in Venezuela and China to more than 35 per 100000 person years in Finland and Sardinia. Furthermore, recent studies suggest a higher rate of increase in disease among children younger than 5 years than in children between 5 and 15 years of age [8,9,10,11], although other studies have not observed a differential rise in incidence [12,13,14].…”