Incidence of Type 1 Diabetes May Be Underestimated in the Chinese Population: Evidence From 21.7 Million People Between 2007 and 2017

Abstract

OBJECTIVE Previous reports of the annual incidence of type 1 diabetes (T1D) in China were conducted using retrospective hospital cases, which may not reflect the reality. This longitudinal study estimated T1D incidence in a Chinese population of 21.7 million from 2007 to 2017. RESEARCH DESIGN AND METHODS A population-based registry of T1D was performed by the Beijing Municipal Health Commission Information Center. Annual incidence and 95% CIs were calculated by age group and sex. The association of sex with T1D incidence and predicted new cases of T1D were assessed using Poisson regression models. Annual percentage change and average annual percentage of change were assessed using Joinpoint regression. RESULTS Overall, there were 6,875 individuals who developed T1D from 2007 to 2017 in this population. T1D incidence (/100,000 persons) (95% CI) significantly increased from 2.72 (2.51, 2.93) in 2007 to 3.60 (3.38, 3.78) in 2017 (P < 0.001). The T1D onset peak was in the 10–14-year-old age group. While no significant trend was found in the 0–14- and 15–29-year-old age groups, T1D incidence markedly increased from 1.87 to 3.52 in the ≥30-year-old age group (P < 0.05). The prevalence of diabetic ketoacidosis at diagnosis was highest in the 0–4-year-old age group. We predicted new cases of T1D will increase 1.57-fold over the next decade. CONCLUSIONS T1D incidence in this large Chinese population is higher than has been reported previously. From 2007 to 2017, although the incidence peak was in the 10–14-year age group, the T1D incidence increased sharply in adults but not in youth.

Clinical Incidence and Characteristics of Newly Diagnosed Type 1 Diabetes in Chinese Children and Adolescents: A Nationwide Registry Study of 34 Medical Centers

“…The peak period of disease onset was in school-aged children (aged 5 to <10 years, 38.7%), which is similar to the report of the SEARCH (SEARCH for Diabetes in Youth) study in the United States ( 21 ). Women had a slightly higher morbidity of T1DM, consistent with the previous findings ( 4 ), which may be one of the features of childhood T1DM in China. Although obesity is associated with the increasing presentation of T1DM for a potentially excess β-cell stress ( 22 , 23 ), the patients were rarely obese at diagnosis in our study.…”

“…The global average increase in incidence has been 3–4% per year over the past decades, with an especially steeper rise in low-incidence countries ( 3 ). The incidence of T1DM remains unstable in China, a longitudinal population-based registry study showed that it significantly increased from 2.72/100,000 in 2007 to 3.60/100,000 in 2017 ( 4 ). One nationwide registry study based on multiple centers showed that the incidence of T1DM in children aged between 0 and 14 years was 1.9/100,000 ( 5 ).…”

Effect of the Chinese New Year Public Holiday on the Glycemic Control of T1DM With Intensive Insulin Therapy

“…A population based study has shown that China has 13,000 newly diagnosed type 1 diabetes mellitus (T1DM) cases every year despite a low incidence rate of 1.01/100,000 person-years from 2010 to 2013 ( 1 ). A recent longitudinal study has demonstrated that T1DM incidence increased from 2.72 to 3.60/100,000 person-years in a Chinese population from 2007 to 2017 ( 2 ). The aims of T1DM management are to avoid acute diabetic complications and prevent or delay chronic diabetic complications and mortality as well as maintain quality of life ( 3 ).…”

Efficacy and Safety of LY2963016 Insulin Glargine in Chinese Patients with Type 1 Diabetes Previously Treated with Insulin Glargine (Lantus®): a Post Hoc Analysis of a Randomized, Open-Label, Phase 3 Trial

“…More than 500,000 new cases are diagnosed each year and 22 million people are estimated to be living with T1DM worldwide [ 3 ]. In China, the incidence of T1DM is lower than in Western countries but has been rising steadily over the past decades [ 4 – 6 ]. According to a recent population-based study, the annual incidence of T1DM per 100,000 in China increased from 2.72 in 2007 to 3.60 in 2017 [ 6 ], which is considerably higher than earlier estimates [ 7 ].…”

“…In China, the incidence of T1DM is lower than in Western countries but has been rising steadily over the past decades [ 4 – 6 ]. According to a recent population-based study, the annual incidence of T1DM per 100,000 in China increased from 2.72 in 2007 to 3.60 in 2017 [ 6 ], which is considerably higher than earlier estimates [ 7 ]. The economic burden of T1DM is substantial, with costs per patient that exceed those of type 2 diabetes mellitus (T2DM) [ 8 ].…”