Decreased Incidence of Type 1 Diabetes in Young Finnish Children

2020 ◽  
Author(s):  
Anna Parviainen ◽  
Anna But ◽  
Heli Siljander ◽  
Mikael Knip ◽  
the Finnish Pediatric Diabetes Register
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Age Groups ◽  
Incidence Rates ◽  
Islet Autoimmunity ◽  
Disease Rate ◽  
Age Group ◽  
Group A ◽  
Design And Methods

OBJECTIVE <p>The incidence of type 1 diabetes has been rising for decades, particularly among young children. Between 2006 and 2011 the incidence rate reached a plateau in Finland. In this observational register-based cohort study, we assess recent trends in the disease rate in Finnish children.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Based on data from the Finnish Pediatric Diabetes Register, we studied the incidence of type 1 diabetes among children under the age of 15 years between 2003 and 2018. We assessed sex-specific incidence rates (IRs) per 100,000 person years (PY) by 4-year time periods in three age groups (0.50–4.99, 5.00–9.99, and 10.00–14.99 years).</p> <p>RESULTS</p> <p>Among the 7,871 children with newly diagnosed type 1 diabetes, the median age at diagnosis increased from 7.88 to 8.33 (<i>P </i>= 0.001), while the overall IR decreased from 57.9/100,000 PY in 2003–2006 to 52.2/100,000 PY in 2015–2018, yielding an IR ratio (IRR) of 0.90 (95% CI 0.85–0.96, <i>P </i>= 0.001). This decline was mainly due to the decrease in the youngest age group [IRR 0.77 (95% CI 0.68–0.87); <i>P </i>< 0.001], being significant both among males and females. In the middle age group, a significant decrease was observed only among females. No changes were observed in the oldest children.</p> <p>CONCLUSIONS</p> <p>The incidence of type 1 diabetes decreased among young Finnish children between 2003 and 2018. Current findings imply that environmental factors driving the immune system towards islet autoimmunity are changing in young children.</p>

scholarly journals Decreased Incidence of Type 1 Diabetes in Young Finnish Children

2020 ◽  
Author(s):  
Anna Parviainen ◽  
Anna But ◽  
Heli Siljander ◽  
Mikael Knip ◽  
the Finnish Pediatric Diabetes Register
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Age Groups ◽  
Incidence Rates ◽  
Islet Autoimmunity ◽  
Disease Rate ◽  
Age Group ◽  
Group A ◽  
Design And Methods

OBJECTIVE <p>The incidence of type 1 diabetes has been rising for decades, particularly among young children. Between 2006 and 2011 the incidence rate reached a plateau in Finland. In this observational register-based cohort study, we assess recent trends in the disease rate in Finnish children.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Based on data from the Finnish Pediatric Diabetes Register, we studied the incidence of type 1 diabetes among children under the age of 15 years between 2003 and 2018. We assessed sex-specific incidence rates (IRs) per 100,000 person years (PY) by 4-year time periods in three age groups (0.50–4.99, 5.00–9.99, and 10.00–14.99 years).</p> <p>RESULTS</p> <p>Among the 7,871 children with newly diagnosed type 1 diabetes, the median age at diagnosis increased from 7.88 to 8.33 (<i>P </i>= 0.001), while the overall IR decreased from 57.9/100,000 PY in 2003–2006 to 52.2/100,000 PY in 2015–2018, yielding an IR ratio (IRR) of 0.90 (95% CI 0.85–0.96, <i>P </i>= 0.001). This decline was mainly due to the decrease in the youngest age group [IRR 0.77 (95% CI 0.68–0.87); <i>P </i>< 0.001], being significant both among males and females. In the middle age group, a significant decrease was observed only among females. No changes were observed in the oldest children.</p> <p>CONCLUSIONS</p> <p>The incidence of type 1 diabetes decreased among young Finnish children between 2003 and 2018. Current findings imply that environmental factors driving the immune system towards islet autoimmunity are changing in young children.</p>

scholarly journals Decreased Incidence of Type 1 Diabetes in Young Finnish Children

2020 ◽  
Author(s):  
Anna Parviainen ◽  
Anna But ◽  
Heli Siljander ◽  
Mikael Knip ◽  
the Finnish Pediatric Diabetes Register
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Age Groups ◽  
Incidence Rates ◽  
Islet Autoimmunity ◽  
Disease Rate ◽  
Age Group ◽  
Group A ◽  
Design And Methods

OBJECTIVE <p>The incidence of type 1 diabetes has been rising for decades, particularly among young children. Between 2006 and 2011 the incidence rate reached a plateau in Finland. In this observational register-based cohort study, we assess recent trends in the disease rate in Finnish children.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Based on data from the Finnish Pediatric Diabetes Register, we studied the incidence of type 1 diabetes among children under the age of 15 years between 2003 and 2018. We assessed sex-specific incidence rates (IRs) per 100,000 person years (PY) by 4-year time periods in three age groups (0.50–4.99, 5.00–9.99, and 10.00–14.99 years).</p> <p>RESULTS</p> <p>Among the 7,871 children with newly diagnosed type 1 diabetes, the median age at diagnosis increased from 7.88 to 8.33 (<i>P </i>= 0.001), while the overall IR decreased from 57.9/100,000 PY in 2003–2006 to 52.2/100,000 PY in 2015–2018, yielding an IR ratio (IRR) of 0.90 (95% CI 0.85–0.96, <i>P </i>= 0.001). This decline was mainly due to the decrease in the youngest age group [IRR 0.77 (95% CI 0.68–0.87); <i>P </i>< 0.001], being significant both among males and females. In the middle age group, a significant decrease was observed only among females. No changes were observed in the oldest children.</p> <p>CONCLUSIONS</p> <p>The incidence of type 1 diabetes decreased among young Finnish children between 2003 and 2018. Current findings imply that environmental factors driving the immune system towards islet autoimmunity are changing in young children.</p>

scholarly journals Incidence of Type 1 Diabetes May Be Underestimated in the Chinese Population: Evidence From 21.7 Million People Between 2007 and 2017

2021 ◽  
Author(s):  
Chang Liu ◽  
Ying-Chao Yuan ◽  
Mo-Ning Guo ◽  
Zhong Xin ◽  
Guan-Jie Chen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Chinese Population ◽  
Age Groups ◽  
Population Based ◽  
Annual Incidence ◽  
Age Group ◽  
And Gender ◽  
Population Based Registry ◽  
Design And Methods

OBJECTIVE─ Previous reports of the annual incidence of type 1 diabetes (T1D) in China were conducted using retrospective hospital cases, which may not reflect the reality. This longitudinal study estimated T1D incidence in a 21.7-million Chinese population during 2007-2017. <p>RESEARCH DESIGN AND METHODS─ A population-based registry of T1D was performed by the Beijing Municipal Health Commission Information Center. Annual incidence and 95% confidence intervals (CI) were calculated by age group and gender. The association of gender with T1D incidence and predicted new T1D cases were assessed using Poisson regression models. Annual percentage change and average annual percentage of change were assessed using Joinpoint regression. </p> <p>RESULTS─ Overall, there were 6,875 individuals who developed T1D from 2007 to 2017 in this population. T1D incidence [95% CI] (/100,000 persons) significantly increased from 2.72 [2.51, 2.93] in 2007 to 3.60 [3.38, 3.78] in 2017 (p<0.001). The T1D onset peak was in the 10-14 age group. While no significant trend was found in the 0-14 and 15-29 age groups, T1D incidence markedly increased from 1.87 to 3.52 in ≥30 age group (p<0.05). The prevalence of diabetic ketoacidosis at diagnosis was highest in 0-4 age group. We predicted T1D new cases will increase to 1.57-fold over the next decade. </p> CONCLUSIONS─ T1D incidence in this large Chinese population is higher than has been reported previously. During 2007-2017, although the incidence peak was in the 10-14 age group, the T1D incidence increased sharply in adults but not in youth.

scholarly journals Incidence of Type 1 Diabetes May Be Underestimated in the Chinese Population: Evidence From 21.7 Million People Between 2007 and 2017

2021 ◽  
Author(s):  
Chang Liu ◽  
Ying-Chao Yuan ◽  
Mo-Ning Guo ◽  
Zhong Xin ◽  
Guan-Jie Chen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Chinese Population ◽  
Age Groups ◽  
Population Based ◽  
Annual Incidence ◽  
Age Group ◽  
And Gender ◽  
Population Based Registry ◽  
Design And Methods

OBJECTIVE─ Previous reports of the annual incidence of type 1 diabetes (T1D) in China were conducted using retrospective hospital cases, which may not reflect the reality. This longitudinal study estimated T1D incidence in a 21.7-million Chinese population during 2007-2017. <p>RESEARCH DESIGN AND METHODS─ A population-based registry of T1D was performed by the Beijing Municipal Health Commission Information Center. Annual incidence and 95% confidence intervals (CI) were calculated by age group and gender. The association of gender with T1D incidence and predicted new T1D cases were assessed using Poisson regression models. Annual percentage change and average annual percentage of change were assessed using Joinpoint regression. </p> <p>RESULTS─ Overall, there were 6,875 individuals who developed T1D from 2007 to 2017 in this population. T1D incidence [95% CI] (/100,000 persons) significantly increased from 2.72 [2.51, 2.93] in 2007 to 3.60 [3.38, 3.78] in 2017 (p<0.001). The T1D onset peak was in the 10-14 age group. While no significant trend was found in the 0-14 and 15-29 age groups, T1D incidence markedly increased from 1.87 to 3.52 in ≥30 age group (p<0.05). The prevalence of diabetic ketoacidosis at diagnosis was highest in 0-4 age group. We predicted T1D new cases will increase to 1.57-fold over the next decade. </p> CONCLUSIONS─ T1D incidence in this large Chinese population is higher than has been reported previously. During 2007-2017, although the incidence peak was in the 10-14 age group, the T1D incidence increased sharply in adults but not in youth.

scholarly journals An Age-Related Exponential Decline in the Risk of Multiple Islet Autoantibody Seroconversion During Childhood

2021 ◽  
Author(s):  
Ezio Bonifacio ◽  
Andreas Weiß ◽  
Christiane Winkler ◽  
Markus Hippich ◽  
Marian J. Rewers ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Confidence Interval ◽  
Islet Autoantibodies ◽  
Islet Autoimmunity ◽  
Islet Autoantibody ◽  
Age Related ◽  
At Risk Children ◽  
Exponential Decline ◽  
Design And Methods

<b>Objective</b>. Islet autoimmunity develops prior to clinical type 1 diabetes and includes multiple and single autoantibody phenotypes. The objective was to determine age-related risks of islet autoantibodies that reflect etiology and improve screening for pre-symptomatic type 1 diabetes. <p><b>Research Design and Methods</b>. The Environmental Determinants of Diabetes in the Young study prospectively followed 8,556 genetically at-risk children at 3–6-month intervals from birth for the development of islet autoantibodies and type 1 diabetes. The age-related change in the risk of developing islet autoantibodies was determined using landmark and regression models. </p> <p><b>Results</b>. The 5-year risk of developing multiple islet autoantibodies was 4.3% (95% confidence interval, 3.8–4.7) at 7.5 months of age and declined to 1.1% (95% confidence interval, 0.8–1.3) at a landmark age of 6.25 years (<i>P</i><0.0001). Risk decline was slight or absent in single insulin- and GAD-autoantibody phenotypes. The influence of sex, <i>HLA</i> and other susceptibility genes on risk subsided with increasing age and was abrogated by age six years. Highest sensitivity and positive predictive value of multiple islet autoantibody phenotypes for type 1 diabetes was achieved by autoantibody screening at 2 years and again at 5–7 years of age. </p> <p><b>Conclusions</b>. The risk of developing islet autoimmunity declines exponentially with age and the influence of major genetic factors on this risk is limited to the first few years of life. </p>

scholarly journals Association of type 1 diabetes and concentrations of drinking water components in Newfoundland and Labrador, Canada

2018 ◽  
Vol 6 (1) ◽  
pp. e000466 ◽  
Author(s):  
Roger Chafe ◽  
Rana Aslanov ◽  
Atanu Sarkar ◽  
Peter Gregory ◽  
Alex Comeau ◽  
...  
Keyword(s):  
Water Quality ◽  
Type 1 Diabetes ◽  
Drinking Water ◽  
Newfoundland And Labrador ◽  
Regional Analysis ◽  
Incidence Rates ◽  
Community Based ◽  
Design And Methods ◽  
Incident Cases

ObjectiveTo determine the association between drinking water quality and rates of type 1 diabetes in the Newfoundland and Labrador (NL) population, which has one of the highest incidences of type 1 diabetes reported globally.Research design and methodsThe study used a community-based, case-control design. We first calculated incidence rates of type 1 diabetes at the provincial, regional and community levels. The connection between incidence rates and components in public water supplies were then analyzed in three ways: to evaluate differences in water quality between communities with and without incident cases of type 1 diabetes, and to analyze the relationship between water quality and incidence rates of type 1 diabetes at both the community and regional levels.ResultsThe provincial incidence of type 1 diabetes was 51.7/100 000 (0-14 year age group) for the period studied. In the community-based analysis, there were significant associations found between higher concentrations of arsenic (β=0.268, P=0.013) and fluoride (β=0.202, P=0.005) in drinking water and higher incidence of type 1 diabetes. In the regional analysis, barium (β=−0.478, P=0.009) and nickel (β=−0.354, P=0.050) concentrations were negatively associated with incidence of type 1 diabetes.ConclusionsWe confirmed the high incidence of type 1 diabetes in NL. We also found that concentrations of some components in drinking water were associated with higher incidence of type 1 diabetes, but no component was found to have a significant association across the three different levels of analysis performed.

scholarly journals An Age-Related Exponential Decline in the Risk of Multiple Islet Autoantibody Seroconversion During Childhood

2021 ◽  
Author(s):  
Ezio Bonifacio ◽  
Andreas Weiß ◽  
Christiane Winkler ◽  
Markus Hippich ◽  
Marian J. Rewers ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Confidence Interval ◽  
Islet Autoantibodies ◽  
Islet Autoimmunity ◽  
Islet Autoantibody ◽  
Age Related ◽  
At Risk Children ◽  
Exponential Decline ◽  
Design And Methods

<b>Objective</b>. Islet autoimmunity develops prior to clinical type 1 diabetes and includes multiple and single autoantibody phenotypes. The objective was to determine age-related risks of islet autoantibodies that reflect etiology and improve screening for pre-symptomatic type 1 diabetes. <p><b>Research Design and Methods</b>. The Environmental Determinants of Diabetes in the Young study prospectively followed 8,556 genetically at-risk children at 3–6-month intervals from birth for the development of islet autoantibodies and type 1 diabetes. The age-related change in the risk of developing islet autoantibodies was determined using landmark and regression models. </p> <p><b>Results</b>. The 5-year risk of developing multiple islet autoantibodies was 4.3% (95% confidence interval, 3.8–4.7) at 7.5 months of age and declined to 1.1% (95% confidence interval, 0.8–1.3) at a landmark age of 6.25 years (<i>P</i><0.0001). Risk decline was slight or absent in single insulin- and GAD-autoantibody phenotypes. The influence of sex, <i>HLA</i> and other susceptibility genes on risk subsided with increasing age and was abrogated by age six years. Highest sensitivity and positive predictive value of multiple islet autoantibody phenotypes for type 1 diabetes was achieved by autoantibody screening at 2 years and again at 5–7 years of age. </p> <p><b>Conclusions</b>. The risk of developing islet autoimmunity declines exponentially with age and the influence of major genetic factors on this risk is limited to the first few years of life. </p>

scholarly journals Dietary Glycemic Index, Development of Islet Autoimmunity, and Subsequent Progression to Type 1 Diabetes in Young Children

2008 ◽  
Vol 93 (10) ◽  
pp. 3936-3942 ◽  
Author(s):  
Molly M. Lamb ◽  
Xiang Yin ◽  
Katherine Barriga ◽  
Michelle R. Hoffman ◽  
Anna E. Barón ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Glycemic Index ◽  
Islet Autoimmunity ◽  
Index Development ◽  
Dietary Glycemic Index

scholarly journals Incidence of Type 1 Diabetes Has Doubled in Rome and the Lazio Region in the 0- to 14-Year Age-Group: A 6-Year Prospective Study (2004-2009)

Diabetes Care ◽  
2010 ◽  
Vol 33 (11) ◽  
pp. e140-e140 ◽  
Author(s):  
C. Bizzarri ◽  
P. I. Patera ◽  
C. Arnaldi ◽  
S. Petrucci ◽  
M. L. M. Bitti ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Prospective Study ◽  
Age Group ◽  
Lazio Region ◽  
Group A

scholarly journals The absence of islet autoantibodies in clinically diagnosed older-adult onset type 1 diabetes suggests an alternative pathology, advocating for routine testing in this age group

2021 ◽  
Author(s):  
Nicholas J Thomas ◽  
Helen C Walkey ◽  
Akaal Kaur ◽  
Shivani Misra ◽  
Nick S Oliver ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Older Adult ◽  
Autoimmune Diabetes ◽  
Genetic Risk Score ◽  
Age Groups ◽  
Islet Autoantibodies ◽  
Age Group ◽  
Adult Onset ◽  
Onset Type

AbstractObjectiveIslet autoantibodies at diagnosis are not well studied in older-adult onset (>30years) type 1 diabetes due to difficulties of accurate diagnosis. We used a type 1 diabetes genetic risk score (T1DGRS) to identify type 1 diabetes aiming to evaluate the prevalence and pattern of autoantibodies in older-adult onset type 1 diabetes.MethodsWe used a 30 variant T1DGRS in 1866 white-European individuals to genetically confirm a clinical diagnosis of new onset type 1 diabetes. We then assessed the prevalence and pattern of GADA, IA2A and ZnT8A within genetically consistent type 1 diabetes across three age groups (<18years (n=702), 18-30years (n=524) and >30years (n=588)).FindingsIn autoantibody positive cases T1DGRS was consistent with 100% type 1 diabetes in each age group. Conversely in autoantibody negative cases, T1DGRS was consistent with 93%(56/60) of <18years, 55%(37/67) of 18-30years and just 23%(34/151) of >30years having type 1 diabetes. Restricting analysis to genetically consistent type 1 diabetes showed similar proportions of positive autoantibodies across age groups (92% <18years, 92% 18-30years, 93% >30years)[p=0.87]. GADA was the most common autoantibody in older-adult onset type 1 diabetes, identifying 95% of autoantibody positive cases versus 72% in those <18years.InterpretationOlder adult-onset type 1 diabetes has identical rates but different patterns of positive autoantibodies to childhood onset. In clinically suspected type 1 diabetes in older-adults, absence of autoantibodies strongly suggests non-autoimmune diabetes. Our findings suggest the need to change guidelines from measuring islet autoantibodies where there is diagnostic uncertainty to measuring at least GADA in all suspected adult type 1 diabetes cases.

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