INCIDENCE, AGE AT ONSET AND SEASONAL VARIATION OF DIABETES MELLITUS IN NORWEGIAN CHILDREN, 1973–1977

ABSTRACT. Joner, G. and Søvik, O. (Department of Paediatrics, University of Bergen, Norway). Incidence, age at onset and seasonal variation of diabetes mellitus in Norwegian children, 1973–1977. Acta Paediatr Scand, 70:329, 1980.–A retrospective study was undertaken to estimate the incidence of diabetes mellitus in Norwegian children. Data were collected from all hospitals in the country and from a central insurance register. Eight hundred and forty-five new cases in the age group 0–14 years and with onset in the five-year study period 1973–1977 were detected. The calculated mean annual incidence was 17.6 per 100000 children, with a year-to-year variation of IS.4–19.3 per 100 000. The geographic variation in incidence was considerable with the lowest rate in the North (6.8/100 000/year) and the highest rates in the South-Eastern part of the country (approx. 20/100000/year). There was a significantly higher incidence for boys (18.8/100 000/year) than for girls (16.4/100 000/year). The age variation in the incidence rates showed rising values towards a peak at 12 years for girls and a plateau at 12–14 years for boys, with an abrupt decline after 12 and 14 years, respectively. There were more cases with onset in the winter and autumn, with significant peaks in February and October. From these data the prevalence of diabetes mellitus in the age group 0–14 years can be calculated to 1.2 per 1 000 children. In the whole of Norway, about 170 new cases of diabetes mellitus below the age of 15 years can be expected every year. Compared with previous studies, the present data suggest an increasing incidence of childhood diabetes in Norway.     

THE INCIDENCE OF DIABETES MELLITUS IN SWEDISH CHILDREN 0–14 YEARS OF AGE

ABSTRACT. This is a prospective study of the incidence of insulin-dependent diabetes mellitus (IDDM) in children 0–14 years of age, including all newly diagnosed cases in the whole of Sweden from July 1, 1977 until June 90, 1980. All 45 Swedish departments of paediatrics participated. During the three-year-period studied, 1108 Swedish children, 0–14 years of age had their onset of diabetes. That means around 369 new diabetics yearly in the age groups studied. The mean yearly incidences in the years 1977–80 were 22.6, 22.8 and 22.6 per 100000 children, respectively. Mean prevalence on June 30, 1980 was 1.48 per 1000 children 0–14 years with a wide range of 0.71-2.65. The age distribution at onset showed a gradual increase and peak incidences at 11 years of age for the girls and 4 and 13 years of age for the boys. There was a consistently higher incidence for boys in the younger age groups during the three-year-period studied. Peak incidences of new cases were reached in January, March and July through October for the age groups 5–9 and 10–14 years of age. No such seasonal variation was seen for children 0–4 years of age. The cumulative incidence of IDDM at 14 years of age was 3.2 per 1000 for the boys and 2.9 per 1000 for the girls. The degree of ascertainment in this study was 93.4 %.     

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 100000 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 100000 population, respectively. The ma1e: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 0-14y is among the lowest in the region, but is rising. □ Children, incidence, insulin-dependent diabetes mellitus, Jordan, type 1 diabetes     

The incidence of diabetes mellitus in Swedish children 0-14 years of age. A prospective study 1977-1980

This is a prospective study of the incidence of insulin-dependent diabetes mellitus (IDDM) in children 0-14 years of age, including all newly diagnosed cases in the whole of Sweden from July 1, 1977 until June 30, 1980. All 45 Swedish departments of paediatrics participated. During the three-year-period studied, 1108 Swedish children, 0-14 years of age had their onset of diabetes. That means around 369 new diabetics yearly in the age groups studied. The mean yearly incidences in the years 1977-80 were 22.6, 22.8 and 22.6 per 100000 children, respectively. Mean prevalence on June 30, 1980 and 1.48 per 1000 children 0-14 years with a wide range of 0.71-2.65. The age distribution at onset showed a gradual increase and peak incidences at 11 years of age for the girls and 4 and 13 years of age for the boys. There was a consistently higher incidence for boys in the younger age groups during the three-year-period studied. Peak incidences of new cases were reached in January, March and July through October for the age groups 5-9 and 10-14 years of age. No such seasonal variation was seen for children 0-4 years of age. The cumulative incidence of IDDM at 14 years of age was 3.2 per 1000 for the boys and 2.9 per 1000 for the girls. The degree of ascertainment in this study was 93.4%.     

ORGAN-SPECIFIC ANTIBODIES IN HEALTHY AND DIABETIC CHILDREN AND YOUNG ADULTS

ABSTRACT. 160 children and young adults (aged 7-21 years) and 84 diabetics (aged 2-19 years) were screened for thyroglobulin (TgA), thyroid microsomal (MsA), smooth muscle (SMA), parietal cell (PCA), reticulin (RA), glomerular (GIA) and mitochondrial (MA) antibodies. The diabetics were also screened for islet cell antibodies (ICA). The overall incidence of other antibodies than ICA at the lowest serum titre studied was 18.1 percent for healthy children and 30.9% for diabetic children. The elevation in diabetics is significant ( p <0.01). Females were overrepresented in both groups and had the highest titres of antibodies. The age group 10-14-years was observed to be a special time at which antibody titres became positive. As compared with the controls, diabetics exhibited increased incidence of MsA (4.4 and 11.9% respectively, p <0.001), PCA (5.0 and 10.7% respectively, p <0.05) and RA (3.8 and 9.5% respectively, p <0.05). The presence of ICA or the duration of diabetes showed no correlation with other autoantibodies. The results indicate that autoantibodies at a low titre are a common phenomenon. Diabetics seem to be susceptible to react against their own tissue, which is probably associated with their increased frequency of autoimmune diseases.     

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%.     

Prävalenz und Altersverteilung des Diabetes mellitus im Kindesalter in Deutschland

Aim. Our main objective was to estimate the prevalence of diabetes mellitus among children aged 0–14 years in Germany on the basis of the incidence surveys done between 1987 and 1998 in Baden-Wuerttemberg. Methods. Data were collected from the pediatric divisions of hospitals in the state (n = 31) as well as from one hospital specializing in diabetes. Results. The mean incidence of diabetes mellitus type 1 among children aged 0–14 years was 12.9/100,000/year (95% CI 12.37–13.37) for the period covering 1987 to 1998. The prevalence among children aged 0–14 years in Baden-Wuerttemberg was up to December 31, 1998, 0.082% (95% CI 0.078–0.086). Average age at the time of diagnosis was 8.7 years among boys and 8.6 years among girls. Conclusions. It is possible to extrapolate the incidence of diabetes mellitus for Germany as a whole on the basis of the results from Baden-Wuerttemberg. Calculations done accordingly show that the total number of diabetic children in the Federal Republic is 11,000 for children aged 0–14 years. Such estimates are fundamental for the further development of medical infrastructures in the field of pediatric diabetes.     

THE INCIDENCE OF DIABETES MELLITUS IN SWEDISH CHILDREN 1970–1975

ABSTRACT. report a retrospective study of diabetic children, 0–14 years of age, from seven Swedish departments of paediatrics. There were 359 new cases in the years 1970–1975. Notification suggested that there was a mean yearly incidence of 19.6 cases per 100000 with a year to year variation of 10.0–26.4 per 100000. Consequently about 330 new cases of childhood diabetes would be expected in Sweden every year. Incidence varied considerably between different geographical areas. The age distribution was bimodal with a main peak at about 12 years and another peak at about 7 years. There was some evidence for clustering of new cases in January and the autumn. The mean prevalence of childhood diabetes in the seven districts was 1.3 per 1000.     

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.     

Insulin dependent diabetes in under 5 year olds.

Insulin dependent diabetes mellitus presenting in children under five years old exhibits several clinical and management features that differ from diabetes presenting in older children. In this review of the current population of the Oxford children''s diabetes clinic, children with diabetes diagnosed aged 0- less than 5 years are compared with those diagnosed aged 5- less than 10 years to illustrate these differences. The mean annual age specific incidence of diabetes for children aged 0- less than 5 is 9.9/100 000 compared with 13.8/100 000 for the children diagnosed aged 5- less than 10. Although children with diabetes currently aged less than 5 comprise only 8% of the clinic population, such children ultimately make up 41% of the total number of children with diabetes aged under 15 attending the clinic. Diabetes diagnosed in children under the age of 5 seems to have increased in incidence over the past 10 years, exhibits a male preponderence (1.5:1), and shows an unusual seasonal variation in incidence with an autumn/early winter trough, late winter/early spring peak, and the absence of mid-summer trough seen in other age groups. First degree family history was positive in 16% of children diagnosed under the age of 5 compared with 10% of the group diagnosed aged 5- less than 10. In none of these children was the mother the affected relative.     

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.     

Epidemilogy of Insulin-Dependent Diabetes Mellitus in Korea

The prevalence of diabetes mellitus in the age group5–16 years, determined from 13,152 subjects residing in Kwangju, Chonnam Provice was 0.099 per cent or 98.9/100,000 in a study performed from December, 1976 to June 1977. On the other hand an epidemiologic study carried out on 254,835 subjects in the age groups14–15 and17–18 years from March 1981 to March 1982 in Seoul City revealed on overall prevalence of 7.85/100,000. In a retrospective study, 88.0/100,000 or out of a total of 10,228 pediatric inpatients were confirmed casesw of insulin-dependent diabetes mellitus, during 7 years and 2 months (from january 1974 to March 1981) at a general hospital located in Jeonju City. The wide range in the prevalence and incidence figures of diabetes mellitus in Korean children probably resulted from lack of uniformity in epidemiological methodology and the degree of ascertainment. The adge distribution at onset of diabetes mellitus showed a gradual incdrease and peak incidences at 3,8 and 12 years of age. The4 sex difference in incidence was not obvious, though girls slightly outnumbered boys. Seasonal variation at onset of diabetes mellitus showed the highest frequency of new cases in winter and spring months.     

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.     

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.     

Incidence of insulin dependent diabetes mellitus in Karachi, Pakistan

OBJECTIVES: To determine the incidence of insulin dependent diabetes mellitus (IDDM) among children aged up to 16 years residing in the city of Karachi, Pakistan, during the five years from 1989 to 1993. DESIGN: Retrospective study of incidence using hospital and clinic records. SETTING: The city of Karachi, Pakistan. SUBJECTS: Children satisfying standard criteria for the diagnosis of IDDM, attending treatment facilities for the first time during the study period. MAIN OUTCOME MEASURES: The incidence of IDDM in this population and its variation by age and sex. RESULTS: The incidence of IDDM in this population is 1.02/100000 per year, which is one of the lowest incidence rates yet reported. CONCLUSIONS: The very low incidence of IDDM, contrasted with the substantially higher incidence among migrants, supports the view that environmental factors are the major determinants of variations in the incidence of this condition between populations.     

Organ-specific antibodies in healthy and diabetic children and young adults

160 children and young adults (aged 7-21 years) and 84 diabetics (aged 2-19 years) were screened for thyroglobulin (TgA), thyroid microsomal (MsA), smooth muscle (SMA), parietal cell (PCA), reticulin (RA), glomerular (GIA) and mitochondrial (MA) antibodies. The diabetics were also screened for islet cell antibodies (ICA). The overall incidence of other antibodies than ICA at the lowest serum titre studied was 18.1 percent for healthy children and 30.9% for diabetic children. The elevation in diabetics is significant (p less than 0.01). Females were overrepresented in both groups and had the highest titres of antibodies. The age group 10-14 years was observed to be a special time at which antibody titres became positive. As compared with the controls, diabetics exhibited an increased incidence of MsA (4.4 and 11.9% respectively, p less than 0.001), PCA (5.0 and 10.7% respectively, p less than 0.05) and RA (3.8 and 9.5% respectively, p less than 0.05). The presence of ICA or the duration of diabetes showed no correlation with other autoantibodies. The results indicate that autoantibodies at a low titre are a common phenomenon. Diabetics seem to be susceptible to react against their own tissue, which is probably associated with their increased frequency of autoimmune diseases.     

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.     

Childhood poisoning in Queensland: an analysis of presentation and admission rates

OBJECTIVE: To determine the presentation rates for paediatric poisoning by ingestion and the determinants of hospital admission. METHODOLOGY: Cross-sectional survey using an injury surveillance database from emergency departments in South Brisbane, Mackay and Mt Isa, Queensland, from January 1998 to December 1999. There were 1516 children aged 0-14 years who presented following ingestional poisoning. RESULTS: The presentation rates for poisoning were 690, 40 and 67 per 100000 population aged 0-4, 5-9 and 10-14 years, respectively. The admission rates to hospital for poisoning were 144, 14 and 22 per 100000 population aged 0-4, 5-9 and 10-14 years, respectively. Although presentation rates for poisoning were higher in the rural centres the admission rates were disproportionately high for the 0-4 years age group. The agents most frequently ingested were paracetamol, Dimetapp, rodenticides and essential oils. CONCLUSION: There is a need to design and implement interventions aimed at reducing poison exposures and unnecessary hospital admissions in the 0-4 years age group.     

Epidemiological situation of tuberculosis in children and youth of Poland

After the Second World War tuberculosis was a very serious health problem in Poland. Tuberculosis in children and youth constituted an important part of the morbidity in the whole population. In 1957 almost 27% of newly detected cases concerned children (19.9%) and adolescents (7%). This percentage decreased systematically through 15.1% in 1965 to 3,0% of total morbidity in 1999 (0.8% in children aged 0-14 and 2.2% in youth aged 15-19 years). Improvement was also observed in the general tuberculosis morbidity rate. The number of new cases diagnosed in 1965 was 57511 (morbidity rate per 100000 population was 182.6) and in 1990 the number of new cases diagnosed was 16136 (morbidity rate 42.3 per 100000 population). In 1999 - 12179 new cases in the whole population were registered (morbidity rate 31.5 per 100000 population). The decrease of morbidity in children and adolescents was more rapid than in adults (mean value 8.9%). The number of new tuberculosis cases diagnosed in 1965 in the age group 0-14 was 4248, (43.5 per 100000 population) and fell to 108 new cases in 1999 (1.4 per 100000 population). In the 15-19 years age group in 1965 - 3621 new cases were diagnosed (125.2 per 100000 population) and in 1999 - 265 new cases (8 per 100000 population) were detected. The most common form of tuberculosis in children and in youth as well as in adults is pulmonary tuberculosis.     

Incidence and prevalence of type 1 diabetes in children aged <15 yr in Castilla-Leon (Spain)

OBJECTIVES: To determine the incidence and prevalence of type 1 diabetes in children younger than 15 yr in the Autonomous Community of Castilla-Leon (Spain). RESEARCH DESIGN AND METHODS: All type 1 diabetic cases with onset at <15 yr of age were recorded during 2003-2004. Identified case subjects were ascertained from several sources and the capture-recapture method was used to estimate the completeness of ascertainment. For prevalence, all patients younger than 15 yr with type 1 diabetes at the beginning and at the end of the study were identified. RESULTS: Over the study period, 130 children aged 0-14 yr were diagnosed with type 1 diabetes. The average observed incidence of type 1 diabetes in this population was 22.22/100 000/yr (95% CI 14.57-29.81). Age-standardized incidence was 22.01/100 000/yr (95% CI 18.18-25.83). The highest incidence was observed in the 5-9 yr age-group (32.45/100 000/yr, 95% CI 24.31-40.59). The prevalence at the beginning and at the end of the study was 1.01/1000 and 1.18/1000, respectively. CONCLUSION: Castilla-Leon appears to have one of the highest incidences of childhood type 1 diabetes in Spain, with recent incidence approaching those of some northern European countries.