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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
Patterson, Christoper C. | Queen’s University Belfast, Centre for Public Health, Belfast, United Kingdom | |
Harjutsalo, Valma | Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland | |
Rosenbauer, Joachim | German Diabetes Center, Institute of Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Germany | |
Neu, Andreas | University Childrens Hospital, Tübingen, Germany | |
Cinek, Ondrej | Charles University in Prague and University Hospital Motol, Prague, Czech Republic | |
Skrivarhaug, Torild | Oslo University Hospital, Oslo, Norway | |
Rami-Merhar, Birgit | Medical University of Vienna, Vienna, Austria | |
Soltesz, Gyula | Department of Pediatrics, University of Pécs, Pécs, Hungary | |
Svensson, Jannet | Department of Paediatrics, Herlev University Hospital, Copenhagen, Denmark | |
Parslow, Roger C | University of Leeds, Leeds, UK | |
Castell, Conxa | Advisory Committee on Diabetes in Catalonia, Department of Health, Barcelona, Spain | |
Schoenle, Eugen | University Children’s Hospital, Zurich, Switzerland | |
Bingley, Polly J | University of Bristol, Bristol, UK | |
Dahlquist, Gisela | University of Umea, Umea, Sweden | |
Jarosz-Chobot, Przemysława | Medical University of Silesia, Katowice, Poland | |
Roche, Edna F. | Trinity College Dublin, University of Dublin, Dublin, Ireland | |
Rothe, Ulrike | Department for Epidemiology and Health Care Research, Technical University of Dresden, Dresden, Germany | |
Bratina, Natasa | University Children’s Hospital, Ljubljana, Slovenia | |
Ionescu-Tirgoviste, Constantin | Institute of Nutrition and Metabolic Diseases N. Paúlescú, Bucharest, Romania | |
Weets, Ilse | Diabetes Research Center, Brussels Free University, Vrije Universiteit Brussel, Brussels, Belgium | |
Kocova, Mirjana | University Children’s Hospital, Skopje, Republic of Macedonia | |
Cherubini, Valentino | Azienda University Hospital, Italy | |
Rojnić Putarek, Nataša | Zagreb University Hospital, Zagreb, Croatia | |
deBeaufort, Carine E. | University of Luxembourg, Luxembourg | |
Samardzic, Mira | Department of Endocrinology and Diabetes, Institute for Sick Children Podgorica, Montenegro | |
Green, Anders | Odense Patient data Exploratory Network, University of Southern Denmark, Odense, Denmark |
| Date Issued |
|---|
2019-03-01 |
First Online: 28 November 2018.
Aims/hypothesis Against a background of a near-universally increasing incidence of childhood type 1 diabetes, recent reports from some countries suggest a slowing in this increase. Occasional reports also describe cyclical variations in incidence, with periodicities of between 4 and 6 years. Methods Age/sex-standardised incidence rates for the 0- to 14-year-old age group are reported for 26 European centres (representing 22 countries) that have registered newly diagnosed individuals in geographically defined regions for up to 25 years during the period 1989–2013. Poisson regression was used to estimate rates of increase and test for cyclical patterns. Joinpoint regression software was used to fit segmented log-linear relationships to incidence trends. Results Significant increases in incidence were noted in all but two small centres, with a maximum rate of increase of 6.6% per annum in a Polish centre. Several centres in high-incidence countries showed reducing rates of increase in more recent years. Despite this, a pooled analysis across all centres revealed a 3.4% (95% CI 2.8%, 3.9%) per annum increase in incidence rate, although there was some suggestion of a reduced rate of increase in the 2004–2008 period. 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), but were higher in boys than girls in the 10- to 14-year-old age group (3.3% and 2.6% per annum, respectively). Significant 4 year periodicity was detected in four centres, with three centres showing that the most recent peak in fitted rates occurred in 2012. Conclusions/interpretation Despite reductions in the rate of increase in some high-risk countries, the pooled estimate across centres continues to show a 3.4% increase per annum in incidence rate, suggesting a doubling in incidence rate within approximately 20 years in Europe. [...].