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Mystery of increase in type 1 diabetes rates

Monday December 3rd, 2018

The number of children being diagnosed with type 1 diabetes is growing by about 3.4% every year – and could double in the next 20 years, according to a new study.

A 25-year study, co-ordinated by Professor Chris Patterson, from the Centre for Public Health, Queen's University Belfast, UK, analysed age/sex-standardised incidence rates for the 0-14 year-old age group in 22 European countries that had registered newly diagnosed individuals in geographically defined regions for up to 25 years between 1989 and 2013.

The results, which are published in the latest edition of Diabetologia, fail to ascertain a specific reason for the increase. The data reveal significant increases in incidence in all but two small centres.

A pooled analysis across all centres revealed a 3.4% per annum increase in incidence rate, although there was some suggestion of a reduced rate of increase in the 2004-2008 period, where it fell to 1.1% per year.

The authors say: "The steadily increasing number of children being diagnosed with this chronic disease, which is associated with well-documented, life-long increases in morbidity and mortality, has important implications for those planning and delivering healthcare.

“The limited success in identifying either environmental causes or gene-environment interactions that could eventually lead to disease prevention means that efforts must continue to improve quality of care to help reduce long-term complications and diabetes-related deaths.

"Key to this is the improvement in blood sugar control that will be achieved not only by more sophisticated methods of insulin delivery, but also by an increased investment in services to support well-trained and dedicated care teams in sufficient numbers to meet the growing needs of this group of children and their families."

Their analysis found that the rates of increase were similar in boys and girls in the 0- to 4-year-old age group (3.7% and 3.7% per annum, respectively) and in the 5- to 9-year-old age group (3.4% and 3.7% per annum, respectively).

However, rates were higher in boys than girls in the 10- to 14-year-old age group (3.3% and 2.6% per annum, respectively). Significant four-year periodicity was detected in four centres – Germany-Saxony, Germany North Rhine-Westphalia, Switzerland, and UK Oxford – with three centres showing that the most recent peak in fitted rates occurred in 2012. However, the authors could find no plausible reason for this cyclical four-year variation.

Patterson C, Harjutsalo V, Rosenbauer j et al. Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: a multicentre prospective registration study. Diabetologia 28 November 2018

https://doi.org/10.1007/s00125-018-4763-3

Tags: Child Health | Diabetes | Europe

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