Trends in childhood type 1 diabetes incidence in E

Authors: C C Patterson E Gyürüs J Rosenbauer O Cinek A Neu E Schober R C Parslow G Joner J Svensson C Castell P J Bingley E Schoenle P JaroszChobot B Urbonaité U Rothe C Krzisnik C IonescuTirgoviste I Weets M Kocova G Stipancic M Samardzic C E de Beaufort A Green G G Dahlquist G Soltész

Publish Date: 2012/05/26

Volume: 55, Issue: 8, Pages: 2142-2147

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Abstract

All registers operate in geographically defined regions and are based on a clinical diagnosis Completeness of registration is assessed by capture–recapture methodology Twentythree centres in 19 countries registered 49969 new cases of type 1 diabetes in individuals diagnosed before their 15th birthday during the period studiedAscertainment exceeded 90 in most registers During the 20year period all but one register showed statistically significant changes in incidence with rates universally increasing When estimated separately for the first and second halves of the period the median rates of increase were similar 34 per annum and 33 per annum respectively However rates of increase differed significantly between the first half and the second half for nine of the 21 registers with adequate coverage of both periods five registers showed significantly higher rates of increase in the first half and four significantly higher rates in the second halfThe incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3–4 per annum but the increase is not necessarily uniform showing periods of less rapid and more rapid increase in incidence in some registers This pattern of change suggests that important risk exposures differ over time in different European countries Further time trend analysis and comparison of the patterns in defined regions is warrantedRecent incidence rate trends in childhood type 1 diabetes have been well characterised in publications by the EURODIAB registries in Europe 1 and by the DIAMOND Diabetes Mondiale Project Group worldwide 2 The DIAMOND report described increasing trends in nearly every continent in the 1990s whereas in Europe there was clear evidence that relative increases were highest in central and eastern European countries and in the under5year age group during the period 1989–2003More recent analyses from Norway 3 and Finland 4 suggest that rates of increase were lower in the 1980s with a subsequent acceleration in the 1990s The same pattern is evident in data from Sweden 5 and that analysis additionally raises the possibility that the rapid increase in the 1990s may soon be reversed a reduction in rates having been observed beginning with the 2000 birth cohortThe EURODIAB group has maintained registers of childhood diabetes in a range of European countries since 1989 using standardised methodology and with validation of completeness of ascertainment and these observations from Scandinavia led us to compare incidence rates in the first half of the 20year registration period 1989–1998 with those in the second half 1999–2008

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