Incidence of Insulin-Dependent Diabetes Mellitus in Colorado

Jn, Kostraba; Cai, Yujun; Cruickshanks, K. J.; Rewers, Marian; Gj, Klingensmith; Hp, Chase; Rf, Hamman

doi:10.1097/00001648-199205000-00008

Cited by 55 publications

(39 citation statements)

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“…Given this lack of data, we are unable to determine whether the increase was linear or nonlinear. This is especially important since the previous Colorado IDDM Registry showed no increase in incidence over the first 11 years of this analysis (1978 -1988) (17); however, the model that best fit these data are linear. Moreover, the estimated annual average increase was similar for the entire state of Colorado and for the Denver metropolitan area for which additional years of data collection were available (from 1996 to 2001).…”

Section: Resultsmentioning

confidence: 93%

“…Most populationbased registries have shown an increasing incidence of type 1 diabetes over time (2,4 -12), whereas others have shown no trend (13)(14)(15)(16)(17). Some of the inconsistencies may be attributed to differences in ascertainment and inadequate sample size to detect statistically significant changes over time.…”

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confidence: 99%

“…Data among U.S. youth are limited. The three U.S. registries that have produced the most reliable estimates are the Allegheny County Registry, Pennsylvania (1965Pennsylvania ( -1994 (9,18); the Philadelphia Registry, Pennsylvania (1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999) (19 -21); and the Colorado IDDM Study (1978 -1988) (17,22). These three studies showed similar overall incidence rates of type 1 diabetes in youth; however, the studies had inconsistent results regarding possible trends in the incidence of type 1 diabetes in youth.…”

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confidence: 99%

“…The Colorado IDDM Registry was a statewide diabetes registry developed to ascertain all youth of nonHispanic white and Hispanic origin with physician-diagnosed type 1 diabetes, aged 0 -17 years at diagnosis, from 1 January 1978 to 31 December 1988 (17,22). SEARCH is a six-site, multiethnic, population-based observational study that ascertained all patients with physiciandiagnosed diabetes who were aged 0 -19 years on 31 December 2001, retrospectively, and all new cases of diabetes in youth aged 0 -19 years from 1 January 2002 forward (23).…”

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confidence: 99%

“…A more detailed description of the Colorado IDDM Registry (17,22) and SEARCH Study (23) have been previously published.…”

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confidence: 99%

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Increasing Incidence of Type 1 Diabetes in 0- to 17-Year-Old Colorado Youth

et al. 2007

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OBJECTIVE—We sought to assess the long-term trends in the incidence of type 1 diabetes among non-Hispanic white and Hispanic youth aged 0–17 years from Colorado using data from the Colorado IDDM Study Registry (1978–1988) and SEARCH for Diabetes in Youth (2002–2004). RESEARCH DESIGN AND METHODS—Cases of diabetes were ascertained through physician reporting and hospital databases. Type 1 diabetes was defined as use of insulin within 2 weeks from diagnosis. Completeness of ascertainment was estimated as 97%. Annual average incidence rates (per 100,000/year) and 95% CIs for the time periods were computed. Trends in incidence were assessed by Poisson regression. RESULTS—The incidence of type 1 diabetes was 14.8 (95% CI 14.0–15.6) in 1978–1988 and 23.9 (22.2–25.6) in 2002–2004 for the state of Colorado (P < 0.0001). From 1978 to 2004, the incidence of type 1 diabetes increased by 2.3% (1.6–3.1) per year (P < 0.0001). The increase in incidence was significant for both non-Hispanic white (2.7% [95% CI 1.9–3.6] per year, P < 0.0001) and Hispanic youth (1.6% [0.2–3.1] per year, P = 0.013). CONCLUSIONS—The incidence of type 1 diabetes has increased 1.6-fold among Colorado youth from 1978–1988 to 2002–2004, and both non-Hispanic white and Hispanic youth are affected by this trend.

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Section: Resultsmentioning

confidence: 93%

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confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

“…A more detailed description of the Colorado IDDM Registry (17,22) and SEARCH Study (23) have been previously published.…”

mentioning

confidence: 99%

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Increasing Incidence of Type 1 Diabetes in 0- to 17-Year-Old Colorado Youth

et al. 2007

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Timing of Initial Cereal Exposure in Infancy and Risk of Islet Autoimmunity

Norris¹

2003

JAMA

455

368

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Context Dietary exposures in infancy have been implicated, albeit inconsistently, in the etiology of type 1 diabetes mellitus (DM). Objective To examine the association between cereal exposures in the infant diet and appearance of islet autoimmunity (IA). Design Birth cohort study conducted from 1994 to 2002 with a mean follow-up of 4 years. Setting Newborn screening for HLA was done at St Joseph's Hospital in Denver, Colo. First-degree relatives of type 1 DM individuals were recruited from the Denver metropolitan area. Participants We enrolled 1183 children at increased type 1 DM risk, defined as either HLA genotype or having a first-degree relative with type 1 DM, at birth and followed them prospectively. We obtained exposure and outcome measures for 76% of enrolled children. Participants had variable lengths of follow-up (9 months to 9 years). Main Outcome Measures Blood draws for the detection of insulin autoantibody, glutamic acid decarboxylase autoantibody, or IA-2 autoantibody were performed at 9, 15, and 24 months and annually thereafter. Children with IA (n=34) were defined as those testing positive for at least 1 of the autoantibodies on 2 or more consecutive visits and who tested positive or had diabetes on their most recent visit. Results Children initially exposed to cereals between ages 0 and 3 months (hazard ratio [HR], 4.32; 95% confidence interval [CI], 2.0-9.35) and those who were exposed at 7 months or older (HR, 5.36; 95% CI, 2.08-13.8) had increased hazard of IA compared with those who were exposed during the fourth through sixth month, after adjustment for HLA genotype, family history of type 1 DM, ethnicity, and maternal age. In children who were positive for the HLA-DRB1*03/04,DQB8 genotype, adjusted HRs were 5.55 (95% CI, 1.92-16.03) and 12.53 (95% CI, 3.19-49.23) for initial cereal exposure between ages 0 to 3 months and at 7 months or older, respectively. Conclusion There may be a window of exposure to cereals in infancy outside which initial exposure increases IA risk in susceptible children.

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