Epidemiology of childhood type I diabetes in Crete, 1990-2001

AIM: To study the epidemiological patterns of childhood-onset type I diabetes in Crete, Greece. METHODS: The incidence (new cases per 100,000 per year) from 1990 to 2001 was determined in the population of Crete < or = 14 y of age. RESULTS: A total of 89 cases was ascertained. The standardized annual incidence rate was 6.1 per 100,000 population [95% confidence interval (95% CI) 4.9-7.5]. Incidence rates were higher in children 10-14 y of age, boys and residents of urban areas (6.8, 6.7 and 6.6 per 100,000, respectively). Incidence rates were higher [relative risk (RR) 1.46, 95% CI 0.956-2.24] during the 6 y period 1996-2001 (7.2, 95% CI 5.4-9.4) than during the 6 y period 1990-1995 (4.9, 95% CI 3.4-6.9). This increase was more prominent in residents of urban areas and 10-14-y-old children. CONCLUSIONS: Although an increase was noted during the period 1990-2001, the childhood type I diabetes incidence rates in Crete remain among the lowest both in Europe and in the Mediterranean islands.     

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

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.     

Increase in the incidence of type 1 diabetes mellitus in children in three cities in Poland, 1987-1999

The aim of this study was to evaluate the trends in the incidence of type 1 diabetes mellitus (DM) in children aged 0-14 years between 1987 and 1999 in three cities in Poland. The study area comprised the provinces of Cracow and Wroclaw and the city of Warsaw. The data were collected prospectively on the basis of the register within the framework of the EURODIAB study up till 1997 and then within the project of the Ministry of Health. During the 13 years of the study period, 766 children (380 girls, 386 boys) with newly diagnosed type 1 DM were identified. The overall age-standardized incidence rates were 8.4/100,000 standardized population/year (95% CI 7.4-9.3) for Cracow province, 6.5/100,000/year (95% CI 5.6-7.4) for Wroclaw province and 7.9/100,000/year (95% CI 6.9-8.8) for Warsaw. A significant trend of increase for children aged 0-14 years was found in the three cities. The analysis of the trend in age subgroups showed a significant increase in incidence in all three age subgroups in Warsaw and Cracow province (0-4 year-old children, p <0.05; 5-9 year-olds, p <0.001 in Cracow province, p <0.05 in Warsaw, and in 10-14 year-olds, p <0.05 in Cracow province, p <0.005 in Warsaw). In the Wroclaw province a significant increase was observed in children aged 0-4 years (p <0.05) and 5-9 years (p <0.001). In children aged 10-14 years the increase was not statistically significant. The results of our study showed that the incidence of type 1 DM in children is rising. A similar phenomenon is occurring in many other countries. The greatest increase of incidence was observed in the 5-9 year-old subgroup of children in Cracow and Wroclaw provinces and in children aged 10-14 years in Warsaw. The incidence rates in excess of 9.0/100,000 per year observed since 1996 have placed Poland in the group of countries with low to medium incidence.     

Epidemiology of diabetes mellitus in children in Hong Kong: the Hong Kong childhood diabetes register

OBJECTIVES: To establish a registry for Chinese children with onset of type 1 (insulin dependent) diabetes mellitus before 15 years of age and to determine the incidence of childhood onset type 1 diabetes mellitus in Chinese children in Hong Kong. RESEARCH DESIGN AND METHODS: A registry was established in 1997 to collect childhood diabetes cases retrospectively from all districts in Hong Kong. The study included all newly diagnosed cases of diabetes with onset < 15 yr of age from 1st January 1984 to 31 December 1996. Primary ascertainment was based on review of medical records at all regional public hospitals in Hong Kong and survey of all the registered practitioners in Hong Kong. The secondary source of validation was made impractical, if not impossible, because of the recent implementation of the Personal Data Privacy Ordinance in Hong Kong. RESULTS: A total of 255 diabetic cases were identified, 227 type 1 diabetes mellitus (218 were Chinese), 18 type 2 diabetes mellitus and 11 secondary diabetes. 246 patients were Chinese and 9 non-Chinese. The age-standardized incidence of type 1 and type 2 diabetes mellitus in southern Chinese children in Hong Kong was 1.4/100,000/yr and 0.1/100,000/yr respectively for children < 15 yr of age during the study period. The incidence rates for type 1 diabetes were 0.9, 1.5 and 1.7 per 100,000/yr for 0-4 years, 5 to 9 years and 10 to 14 years age-groups respectively. The incidence for males was 1.2/100,000/yr and for females 1.7/100,000/yr. A significant increase in the incidence was demonstrated during the study period by simple linear regression (slope 0.14/100,000/year, r2 = 0.73, p = 0.0002) CONCLUSIONS: A diabetic registry is established in Hong Kong. This study documents a very low incidence rate of childhood type 1 diabetes mellitus in southern Chinese children in Hong Kong and we have seen an increasing incidence of the disease in the past 13 years.     

Significant urban/rural differences in the incidence of type 1 (insulin-dependent) diabetes mellitus among Bulgarian children (1982-1998)

The systematic registration of the incidence of childhood (0-14 yr) type 1 (insulin-dependent) diabetes mellitus in Bulgaria dates back to 1973, with an invariably present difference in the incidence according to the area of residence. The present study has been undertaken to assess the trends in the incidence of type 1 diabetes among children in eastern Bulgaria (1982-1998) with respect to area of residence at onset. The data were collected prospectively, with an ascertainment of the primary source of 95.8%. The mean annual incidence is 6.99/100,000 (95% CI = 6.45-7.54), varying between 5.09 and 11.54/100,000. The mean annual incidence in towns is higher than in villages: 7.89 vs. 5.26/100,000, p < 0.0001. A linear trend of increase in the incidence with time is revealed applying Poisson regression analysis, with the area of residence as a strong predictor of the risk (p < 0.001). According to the model, the age-adjusted incidence rose by 4.1% annually. The stratified analysis by age group has found a significant linear trend in those aged 5-9 (p < 0.001) and 10-14 yr (p = 0.002) for both sexes. In conclusion, the markedly increasing incidence of type 1 diabetes among children in this study is strongly dependent on area of residence at onset. We suggest that in conjunction with the pronounced seasonality at the onset of diabetes and its connection with population density, this phenomenon should be regarded as a reflection of environmental influence and further explored.     

Rising incidence of type 1 diabetes in Scottish children, 1984-93. The Scottish Study Group for the Care of Young Diabetics

OBJECTIVES: To calculate the incidence of type 1 diabetes in Scottish children aged less than 15 years between 1984 and 1993; to examine changes in incidence; and to calculate the prevalence of diabetes at the end of this period. DESIGN: Three data sources were used to construct the Scottish Study Group for the Care of Young Diabetics register: active reporting of all new cases; reports from the Scottish Morbidity Register 1; and local registers. SUBJECTS: All children resident in Scotland diagnosed with primary insulin dependent diabetes mellitus when less than 15 years of age between 1984 and 1993. MAIN OUTCOME MEASURES: Annual incidence and prevalence rate for Scotland; time trend in incidence over the 10 years; differences in incidence between the three different age groups; and completeness of the register. RESULTS: The average annual incidence for Scotland was 23.9/100,000 children. The prevalence rate was 1.5/1000 in 1993. A total of 2326 cases was identified from the three sources. Capture-recapture analysis suggests a case ascertainment of 98.6%. The annual incidence rates increased at a rate of 2% each year (rate ratio = 1.02, 95% confidence interval (CI) 1.01 to 1.03). The incidence was higher in boys than girls (rate ratio = 1.08, 95% CI 1.00 to 1.18), and the incidence rates increased with age: 15.3/100,000/year for age 0-4 years, 24.4/ 100,000/year for age 5-9 years, and 31.9/ 100,000/year for age 10-14 years. CONCLUSIONS: The incidence of type 1 diabetes in Scotland is increasing and the prevalence is relatively high. These findings have important implications for health service resource allocation. The Scottish Study Group for the Care of Young Diabetics' register provides a base for monitoring and research.     

Epidemiology of bacterial meningitis.

This 10 year retrospective study of all causes of bacterial meningitis for children resident in Nottingham District Health Authority area reports an annual incidence rate per 100,000 children aged 0-16 years of 16.0 (95% confidence interval 14.0 to 18.1). There was a steady increase in incidence from 9.6/100,000 in 1980 to 24.3/100,000 in 1989. This was mainly due to an increase in the incidence of meningococcal infections in the age group 1 month to 5 years. Incidence rates varied with age being: 37.2/100,000 (25.9 to 53.5) for 0-28 days of age, 115.5/100,000 (93.9 to 141.9) for 1-11 months of age, 28.5/100,000 (23.1 to 35.3) for 12-59 months of age, and 2.8/100,000 (1.9 to 4.1) for 5-16 years of age. Overall annual mortality incidence per 100,000 was 1.8 (1.2 to 2.8). For the different age groups this was: 10.1 (4.8 to 21.1) for 0-28 days, 11.5 (6.0 to 22.2) for 1-11 months, 1.0 (0.3 to 3.1) for 12-59 months, and 0.4 (0.1 to 1.2) for 5-16 years of age. There were interactions between the type of meningitis and the year of the infection on the mortality rate. Mortality decreased in those with infections caused by bacteria other than Neisseria meningitidis and Haemophilus influenzae.     

Incidence of type I diabetes among children and young adults (0-29 years) in the province of Badajoz, Spain during 1992 to 1996

In this study, we determine the incidence of Type I (insulin-dependent) diabetes mellitus in the 0-29-y-old group in Badajoz (the largest and least developed province of Spain). We test for differences in incidence by age at diagnosis, time cluster and sex. Diabetes clinics and periodic review of hospital administration data provided the primary source of ascertainment. The secondary independent data source was based on registries of local Diabetic Associations and guarantee cards of blood glucose meters. Data were collected retrospectively in the period 1992-95 and prospectively for 1996. During the 5-y period (1992-96), 186 new cases of Type I diabetes were identified. Completeness of ascertainment was 95%. Average annual incidence (95% CI) for the 0-14, 15-29 and 0-29-y-old groups was 17.6/100,000 (14.5-21.2), 8.8/100,000 (6.9-11.1) and 12.8/100,000 (11-14.7). The highest age-specific annual incidence rate was found in the 10-14 age group: 23.4/100,000 (17.6-30.4). The incidence in males (14.7/100,000/y) was higher than in females (10.7/100,000/y). There was a seasonal onset pattern, with the highest incidence in autumn and winter. October was the month with the highest number of new cases (29/186). The province of Badajoz has a moderately high incidence of Type I diabetes in 0-14-y-old children, similar to that found in other more developed and densely populated regions of Spain. These data contradict the hypothesis of a decrease in the incidence of the disease from north to south over Europe.     

Häufigkeit des Diabetes mellitus im Kindesalter in Deutschland Ein epidemiologischer Überblick

A global increase in the occurrence of Type 1 diabetes mellitus during childhood has been observed. In Germany, data on the frequency of diabetes became available only a few years ago. The Baden-Württemberg Incidence Registry is currently the most comprehensive data collection system pertaining to childhood-onset diabetes in Germany; and is affiliated to the EURODIAB data bank, a collaborative European network. The mean standardized sex- and age-specific incidence rate for diabetes mellitus among children aged 0–14 years is 12.9/100,000 per year (95% CI 12.4–13.4), calculated on the basis of the data pool for the period from 1987 to 1998. During this time, it was observed that the incidence rate increased by 47%. This is equivalent to a yearly increase of 3.6%. The prevalence for the age group 0 – 14 years is between 0.08 and 0.09%, whereas it is between 0.13 and 0.15% for the total group under 20 years of age [18]. Our calculations predict a doubling of the incidence rate within 20 years, reaching 24.7/100,000 children a year in the year 2020.     

An increasing trend in the incidence of type 1 diabetes mellitus in children aged 0-14 years in Romania--ten years (1988-1997) EURODIAB study experience

AIM: To assess the incidence of type 1 diabetes mellitus (DM1) in Romanian children aged 0-14 years using EURODIAB Study methodology. METHODS: Data were collected for a 10-year interval (1988-1997) for the whole country, using the capture-recapture method. RESULTS: We registered 1,418 newly diagnosed patients. The mean total incidence rate was 3.051/100,000/year. There was a wide geographic variation (6.71-fold) between the highest and the lowest incidence rates in different districts. We noticed a progressive increase of age-specific incidence rates from 1.43/100,000/year for the 0-4 year age subgroup to 4.37/100,000/year (10-14 years). The annual mean incidence rate rose from 1.91/100,000/year (1988) to 3.94/100,000/year (1996). CONCLUSIONS: Romania is one of the European countries with the lowest incidence rates (3.051/100,000/year) for DM1 in children. There was an evident increasing trend of DM1 incidence in children between 1988 and 1997, with an annual increase of 7.57%.     

Incidence of invasive pneumococcal disease in Sydney children, 1991-96

OBJECTIVE: Few data are available on invasive disease due to Streptococcus pneumoniae in representative Australian childhood populations. This study aimed to determine the age-specific incidence of invasive pneumococcal disease in Sydney children. METHODOLOGY: Population-based prospective study where isolates of Streptococcus pneumoniae from normally sterile sites were identified through an established laboratory surveillance network. Isolates came from children aged under 15 years living within the boundaries of Central, Eastern. Southern, Western and South-western Sydney Area Health Services from 1 July 1991 to 30 June 1996. RESULTS: Invasive pneumococcal disease was identified in 320 children during a 5-year period, of whom 193 (60%) were under 2 years of age. The incidence per 100,000 children was 12.7 per 100,000 (95% CI: 11.4-14.2/100,000) under 15 years; 31.7 (95% CI 28.1-35.7) under 5 years, and 45.5 (95% CI 38.9-53.3) under 2 years. The incidence of pneumococcal meningitis in children aged under 2 years was 10.5 per 100,000 (95% CI: 7.4-14.5/100,000). CONCLUSIONS: The incidence of childhood invasive pneumococcal disease in Sydney was stable during 1991-96 and comparable to rates reported from other industrialized countries. There was no evidence of any change in pneumococcal disease incidence with reduction in invasive Haemophilus influenzae type b (Hib) disease following introduction of Hib immunization.     

Trends in diabetes mellitus among privately insured children, 1998-2002.

OBJECTIVE: To evaluate trends in health care administrative claims for childhood diabetes mellitus. METHODS: We conducted a serial cross-sectional study of a national sample of privately insured children < or = 18 years old. The number of subjects ranged from 306991 in 1998 to 974407 in 2002. We classified diabetes type by 2 schemes: one based on encounter claims only, and the other based on both encounter and pharmacy claims. The prevalence of diabetes was determined after adjusting for demographic changes in the study population, including age, proportion enrolled in managed care, and urban residence. RESULTS: The adjusted prevalence of diabetes overall increased from 183 (95% confidence interval [CI], 169-198) cases per 100,000 enrollees in 1998 to 218 (95% CI, 208-228) cases per 100,000 enrollees in 2002, primarily because of an increase in type 1 diabetes (based on both encounter and pharmacy claims, 135 [95% CI, 123-148] cases per 100000 enrollees in 1998 to 167 [95% CI, 158-176] cases per 100,000 enrollees in 2002). CONCLUSIONS: Our estimate of the overall prevalence of diabetes is consistent with national data. However, our finding that rising prevalence of type 1 diabetes appear to account for most of the increase in diabetes claims is surprising. Future research will be needed to validate these results.     

Marked increase in type 1 diabetes mellitus incidence in children aged 0-14 yr in Victoria, Australia, from 1999 to 2002

OBJECTIVES: The objectives of the study were to (i) determine the incidence of type 1 diabetes mellitus (T1DM) in children aged <15 yr in Victoria, Australia, from 1999 to 2002 and (ii) to analyze trends in incidence over this period. METHODS: Prospective population-based incidence study. The primary source of case ascertainment was from the Australasian Paediatric Endocrine Group (APEG) Victorian diabetes register. The secondary source was the National Diabetes Register (NDR), which ascertains cases from the National Diabetes Service Scheme (NDSS), a Commonwealth government initiative, where patients register to receive diabetes supplies at a subsidized price. MAIN OUTCOME MEASURES: Age-standardized incidence, trends in incidence by age, sex and year, and variation in incidence by region, season, and socioeconomic status. RESULTS: Case ascertainment was 99.1% complete using the capture-recapture method. The mean annual age-standardized incidence was 19.3 per 100 000 person years from 1999 to 2002. On average, incidence increased by 9.3% per year, with a greater relative increase in the 0-4 yr age-group (p = 0.037). No gender bias in incidence was found, but the increase in females was statistically significant (13.6% per year, 95% confidence interval 3.7-24.3). Variation in geographical distribution and seasonal onset of incidence was not statistically significant. CONCLUSIONS: The marked increase in the incidence of T1DM in Victoria is greater than that recently described in other Australia states and developed nations. The etiology of this rise is unclear, while the increased caseload has major implications for diabetes health care providers for current and future resource allocation.     

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

Varicella can cause complications that are potentially serious and require hospitalization. Our current understanding of the causes and incidence of varicella-related hospitalization in Turkey is limited and sufficiently accurate epidemiological and economical information is lacking. The aim of this study was to estimate the annual incidence of varicella-related hospitalizations, describe the complications, and estimate the annual mortality and cost of varicella in children. VARICOMP is a multi-center study that was performed to provide epidemiological and economic data on hospitalization for varicella in children between 0 and 15?years of age from October 2008 to September 2010 in Turkey. According to medical records from 27 health care centers in 14 cities (representing 49.3% of the childhood population in Turkey), 824 children (73% previously healthy) were hospitalized for varicella over the 2-year period. Most cases occurred in the spring and early summer months. Most cases were in children under 5?years of age, and 29.5% were in children under 1?year of age. The estimated incidence of varicella-related hospitalization was 5.29-6.89 per 100,000 in all children between 0-15?years of age in Turkey, 21.7 to 28 per 100,000 children under 1?year of age, 9.8-13.8 per 100,000 children under 5?years of age, 3.96-6.52 per 100,000 children between 5 and 10?years of age and 0.42 to 0.71 per 100,000 children between 10 and 15?years of age. Among the 824 children, 212 (25.7%) were hospitalized because of primary varicella infection. The most common complications in children were secondary bacterial infection (23%), neurological (19.1%), and respiratory (17.5%) complications. Secondary bacterial infections (p?相似文献   

Three-year prevalence and incidence of diabetes among American Indian youth in Montana and Wyoming, 1999 to 2001

OBJECTIVES: To estimate the prevalence and incidence of type 2 diabetes among American Indian youth. STUDY DESIGN: Medical records were reviewed annually for all patients with diabetes who were <20 years of age at 6 Indian Health Service facilities in Montana and Wyoming. All cases < or =5 years of age or weight per age < or =10th percentile at diagnosis or with islet cell antibodies were considered as probable type 1. Among the remaining cases, probable type 2 diabetes was defined when a child had one or more of the following characteristics: weight per age > or =95th percentile or acanthosis nigricans at diagnosis, elevated C-peptide or insulin, family history of type 2 diabetes; treatment with oral agents with or without insulin or no hypoglycemic therapy after 1 year of follow-up. RESULTS: From 1999 to 2001, 53% of prevalent cases and 70% of incident cases were categorized as probable type 2 diabetes. The average annual prevalence of probable type 1 and type 2 diabetes was 0.7 and 1.3 per 1000. The average annual incidence rates for probable type 1, and type 2 diabetes were 5.8, 23.3 per 100,000. CONCLUSIONS: The incidence of probable type 2 diabetes was approximately 4 times higher than type 1 diabetes among American Indian youth in Montana and Wyoming     

Polymorphism in the transmembrane region of the MICA gene and type 1 diabetes

Although MHC class II genes have a stronger association with type 1 diabetes than MHC class I genes, studies have shown that MHC class I molecules play an independent role in the etiology of type 1 diabetes, and the existence of susceptibility genes within a segment of MHC between the HLA-B and TNF genes has been predicted, where MHC class I chain-related gene A (MICA) resides. MICA has a triplet repeat polymorphism in the transmembrane region consisting of five alleles. We analyzed this polymorphism in 162 unrelated children (82 boys) with type 1 diabetes (age at diagnosis 7.01 +/- 3.76 yr) and 154 randomly selected unrelated children (87 boys), age 2.81 +/- 2.12 yr. Phenotype frequency of allele A9 in children with type 1 diabetes was significantly higher than in controls (RR = 2.42, 95% CI = 1.52-3.85, p = 0.000162, pc = 0.00081). Gene frequency of allele A9 was also significantly higher in children with type 1 diabetes when compared with control children (RR = 2.73, 95% CI = 1.85-4.03, p = 2.62 x 10(-7), pc = 1.31 x 10(-6)). This study demonstrates that MICA allele A9 confers risk of type 1 diabetes.     

Incidence of insulin-dependent diabetes mellitus in Jordanian children aged 0-14 y during 1992-1996

An attempt was made by the Jordanian National Center for Diabetes, Endocrine and Genetic Diseases (NCDEGD) to identify all cases of type 1 diabetes among Jordanian children aged 0-14 y. Data were obtained retrospectively for the years 1992-1994 and prospectively for the years 1995 and 1996, including full name, national identifying number, date of birth, date of diagnosis and family history. The incidence was calculated as the number of cases per 100,000 population, according to the national census of 1994. The incidence rate for these years (1992 through 1996) was 2.8, 2.9, 3.2, 3.6 and 3.6 per 100,000 population, respectively. The male:female ratio was (1:1.03). Seasonal variation at clinical onset was noticed, with maximum incidence in the winter months and minimum incidence in the summer months. In conclusion, the incidence of type 1 diabetes mellitus in Jordanian children aged 0-14 y is among the lowest in the region, but is rising.     

Time trend of childhood type 1 diabetes incidence in Lithuania and Sweden, 1983-2000

AIM: To compare the time trend of childhood type 1 diabetes over an 18-y period in Lithuania and Sweden--countries with different incidence levels and different socio-economic conditions. METHODS: Percent average incidence change per year between 1983 and 2000, based on 8031 Swedish and 1100 Lithuanian cases in the age group 0-14 y, was calculated using Poisson regression. RESULTS: Average age- and sex-standardized incidence/100 000/y was 28.9 (95% CI: 28.2-29.5) in Sweden and 7.5 (95% CI: 7.1-8.0) in Lithuania. Between 1983 and 2000, the average increase per year was 2.2% in Sweden (95% CI: 1.7-2.6) and 2.3% in Lithuania (95% CI: 1.1-3.5), but the latter trend depended on an increase during the last few years of the period, and only for girls. In Sweden, incidence increased significantly in all age groups, but more so in the younger groups (3.0%, 2.2% and 1.7% per year in 0-4, 5-9 and 10-14-y age groups, respectively), while in Lithuania a significant increase was found only in the 10-14-y age group (3.0%). In Sweden, a trend towards a younger age at diagnosis was indicated for both boys and girls when comparing 1983-1991 and 1992-2000, whereas in Lithuania, the changes in age distribution over time were small, with an opposite tendency for boys. CONCLUSION: Incidence variability over time differed considerably in the two countries in the region of the Baltic Sea, suggesting a complex effect of environmental risk factors, some of which may be associated with wealth and socio-economic conditions.     

Incidence of childhood diabetes mellitus in Austria 1979-1984

The mean annual incidence of childhood diabetes mellitus in Austria was 7.22 cases per 100,000 with a year to year variation of 6.09-8.67 per 100,000. A seasonal variation of onset, with peaks in autumn and winter and with lower rates in summer in children older than 4 years, could be observed. The peak incidence in girls occurred at 11-12 years and preceded the highest incidence in boys by 1-2 years. Both sexes showed a small peak around 6 years of age. The male to female ratio was 1.2/1. Compared to epidemiologic studies in north-western Europe the incidence of childhood diabetes in Austria is low, however higher than in France or Italy.