Twenty-one years of prospective incidence of childhood type 1 diabetes in Hungary - the rising trend continues (or peaks and highlands?)

Abstract

The aim of this study was to examine secular trends in the incidence of type 1 diabetes in children aged 0-14 yr in Hungary over the period 1989-2009. Newly diagnosed children with type 1 diabetes aged 0-14 yr in Hungary were prospectively registered from 1989 to 2009. Primary ascertainment of cases was by prospective registration using hospital notifications. Case ascertainment was over 96% complete using the capture-recapture method. Standardized incidence rates were calculated and secular trends estimated using Poisson regression analysis. In Hungary during 1989-2009 a total number of 3432 children were identified, giving a standardized incidence rate of 12.5 [95% confidence interval (CI) 12.1-12.9] per 100,000 person yr. The overall incidence rate has doubled from 7.7 (95% CI 6.4-9.15) per 100,000 per yr in 1989 to 18.2 (95% CI 15.7-20.9) per 100,000 per yr in 2009. A significant linear trend in incidence (p < 0.001) has been observed over time, with a mean annual increase of 4.4%. The increase in incidence was present in both genders and in all age groups, with the largest relative increase in the youngest age group (6.2%; p < 0.001). The incidence of type 1 diabetes in Hungarian children continues to increase, with the highest rate in the very young. Although it seems that transient periods of stabilization followed by increases in incidence are apparent, the long-term trend continues to be steadily upward. Incidence of childhood type 1 diabetes is a dynamic process, probably reflecting the changes of the environmental exposures and continued registration is necessary to recognize these trends.

Clinical and biochemical features at diagnosis of type 1 diabetes in patients between 0 and 18 years of age from Jordan

“…However, incomplete ascertainment of cases could lead to such observation. This obvious shift to a younger age at diagnosis could be in accordance with the worldwide reported increase in the incidence of T1D in younger age groups . This change has its consequences with a longer burden of disease as well as the immediate challenge of caring for T1D in a toddler .…”

“…This change has its consequences with a longer burden of disease as well as the immediate challenge of caring for T1D in a toddler . This rising trend in incidence over the past decades is hypothesized to be attributed to lifestyle‐related risk factors such as high caloric intake, rapid early growth, and rapid early weight gain . The younger diabetics were reported to have a shorter duration of symptoms with a more abrupt and severe metabolic decompensation .…”

Recent Incidence of Type 1 Diabetes Mellitus in Montenegro: A Shift Toward Younger Age at Disease Onset

“…Two youngest age groups (0-4 and 5-9 years) had the highest relative increase. This is in accordance with other studies reporting the increasing incidence of T1DM mostly in younger age group [11][12][13][14] , but is completely different from data reported in Croatia where the increase in the disease incidence ceased in the youngest children 15 . Similar to some other studies 16,17 , we found a steep increase in the incidence T1DM in Montenegro boys under five years of age.…”

Cyclical variation in the incidence of childhood‐onset type 1 diabetes during 40 years in Navarra (Spain)

“…Regarding sex‐related differences, T1D shows a similar incidence in both sexes in children under 15 years . However, in some studies, T1D is more frequent in boys between 10 and 14 years . As a general rule, it has been noted that in countries with a high incidence of T1D, the disease predominates in boys, while in low incidence countries it is in girls where it prevails .…”