Trends in the incidence of childhood-onset diabetes in Europe 1989–1998

Abstract

In a report presenting data from 1989±1990 from 26 registries in the EURODIAB Study Group, we showed that an exceptionally wide range of incidence rates for Type I diabetes exists within Europe [1]. New research and reviews, including the EURODI-AB Study Group's recent report on the years 1989±1994, indicate that there has been a rapid increase in the incidence of Type I diabetes in many European countries in the last few decades with a higher rate of increase among children under 5 years of age [2±8]. This increase, in conjunction with the relatively low concordance rate in monozygotic twin pairs, highlights the importance of environmental factorsThis report, based on 10 years of prospective registration by the EURODIAB Study Group, updates the knowledge on the epidemiology of childhood diabetes in Europe. Particular attention is given to an analysis of age-specific, secular trends in different parts of Europe. Diabetologia (2001) Results. The standardised average annual incidence rate of Type I diabetes varied more than tenfold between centres. Overall, the annual increase in incidence was 3.2 % (95 %-CI: 2.7 %, 3.7 %), being highest for children in the 0±4-year age-group 4.8 % (3.8 %, 5.9 %) and lowest for children in the 10±14-year age group 2.1 % (1.4 %, 2.8 %). However, the absolute increases in Type I diabetes were roughly similar in the three age-groups of 0±4, 5±9 and 10±14 years. Central Eastern Europe showed the highest increase whereas Sardinia and Northern Europe (except Finland) showed no evidence of an increase. For all age-groups relatively fewer cases had disease onset during the summer months, especially the 10±14-year age-group. Conclusion/interpretation. The extremely large range of incidence rates within Europe has been confirmed. The incidence rate is generally increasing but is more pronounced in some regions than in others. Seasonality at disease onset is apparent even in the youngest agegroup. [Diabetologia (2001)

Prospective incidence study of diabetes mellitus in New Zealand children aged 0 to 14 years

“…The international literature is still unclear as to whether the younger age groups are experiencing greater absolute increases in incidence [16]. We cannot add meaningful data to this issue, as the earlier New Zealand studies do not allow comparisons by age group.…”

Atopic eczema in early childhood could be protective against Type 1 diabetes

“…Additionally, there is substantial evidence from clinical and experimental data that Th1/Th2 balance is important to the development of atopic and autoimmune diseases [2,26,27,28,29,30]. On the other hand, both Type 1 diabetes and atopic diseases have been rising during the last decades [31,32,33,34], according to the 'hygiene hypothesis' possibly due to a decrease of infectious diseases in industrialized countries [35,36]. This apparent paradox that Type 1 diabetes and atopic disorders share common epidemiological characteristics but represent opposite deviations of the immune response remains to be resolved [36].…”

Children developing type 1 diabetes before 6 years of age have increased linear growth independent of HLA genotypes

“…Children developing type 1 diabetes will depend on lifelong treatment with insulin and have a high rate of complications. The incidence of type 1 diabetes in children is increasing [1,2], especially in children below 4 years of age [3][4][5]. The cause of this increasing incidence is still unknown, as is the cause of the disease itself.…”