Aims/hypothesis. To analyse the incidence of Type I (insulin-dependent) diabetes mellitus in the 0-34 years age group in Sweden 1983-1998. Methods. Incidence and cumulative incidence per 100 000 and Poisson regression analysis of age-period effects was carried out using 11 751 cases from two nation-wide prospective registers. Results. Incidence (95%-CI) was 21.4 (20.8-21.9) in men and 17.1 (16.6-17.5) in women between 0 and 34 years of age. In boys aged 0-14 and girls aged 0-12 years the incidence increased over time, but it tended to decrease at older age groups, especially in men. Average cumulative incidence at 35 years was 748 in men and 598 in women. Cumulative incidence in men was rather stable during four 4-year periods (736, 732, 762, 756), while in women it varied more (592, 542, 617, 631). In males aged 0-34 years, the incidence did not vary between the 4-year periods (p=0.63), but time changes among the 3-year age groups differed (p<0.001). In females the incidence between the periods varied (p<0.001), being lower in 1987-1990 compared to 1983-1986, but time changes in the age groups did not differ (p=0.08). For both sexes median age at diagnosis was higher in 1983-1986 than in 1995-1998 (p<0.001) (15.0 and 12.5 years in males; 11.9 and 10.4 in females, respectively). Conclusion/interpretation. During a 16-year period the incidence of Type I diabetes did not increase in the 0-34 years age group in Sweden, while median age at diagnosis decreased. A shift to younger age at diagnosis seems to explain the increasing incidence of childhood Type I diabetes. [Diabetologia (2002) 45:783-791]

The high rate of OW and obesity (31.8%) emphasize the need for developing further strategies to prevent and treat excess fat accumulation in T1D.

OBJECTIVE -To study the association between type 1 diabetes risk and previous intake of energy, accounting for body size and previous intake of nutrients and foods, accounting for the energy intake.RESEARCH DESIGN AND METHODS -We conducted an incident populationbased case-referent study in Stockholm, Sweden, including 99 of 100 eligible 7-to 14-year-old diabetic children and 180 of 200 age-, sex-, and area-matched referent children identified through the Swedish population register. Average daily energy and nutrient intake 1 year before diabetes diagnosis/interview was estimated using the food frequency questionnaire with assessment of consumed food amounts. Mean SD scores of growth measurements taken during the last 4 years before the diagnosis were used. Odds ratios (ORs) were calculated by conditional logistic regression.RESULTS -Average intake of energy, carbohydrate, fat, and protein was significantly higher among the case subjects as well as mean weight-for-age SD score. Higher energy intake and weight-for-age were both associated with increased diabetes risk after adjustment for each other: OR (95% CI) for medium and high levels of energy intake were 1.33 (0.52-3.42) and 5.23 (1.67-16.38), respectively, and for weight-for-age were 3.20 (1.30 -7.88) and 3.09 (1.16 -8.22), respectively. High intake of carbohydrates, especially disaccharides and sucrose, increased diabetes risk.CONCLUSIONS -Higher energy intake and larger body size were independently associated with increased diabetes risk. Of the different nutrients, higher intake of carbohydrates, particularly disaccharides and sucrose, increased the risk. Lifestyle habits leading to higher energy intake and more rapid growth in childhood may contribute to the increase of childhoodonset type 1 diabetes by different mechanisms. Diabetes Care 27:2784 -2789, 2004D ietary intake of certain nutrients and possible toxic food components is of interest in the search for triggers or promoters of the autoimmune ␤-cell destruction that may lead to type 1 diabetes (1-3). Studies of infant diet indicated that short breast-feeding duration and early introduction of cow's milk proteins may be causally related to the development of childhood diabetes (4) and progressive ␤-cell autoimmunity before the age of 4 years (5). Some studies also found that high intake of cow's milk later in childhood is associated with increased risk of diabetes (6,7). In a previous population-based case-referent study, our group showed a dose-response relationship between the risk of developing childhood diabetes and the frequency of intake of foods rich in protein, carbohydrates, and nitrosamines (8). Moreover, the nutrition-associated risk profiles differed between the age-groups (9). Analyzing prospectively recorded childhood growth data, we have also showed that future diabetic children had a higher linear growth rate several years before the diagnosis compared with age-and sex-matched referents (10). Studies from different populations have confirmed that and also found that children who dev...

Obesity rate in children with T1D in the Nordic countries is high, however, with country differences. Low HbA , long diabetes duration, higher insulin dose, pump treatment and experiencing a SH predicted higher BMISDS. Diabetes caregivers should balance the risk of obesity and the benefit of a very low HbA

Aims/hypothesis: We investigated the association between type 1 diabetes and birthweight by age at disease onset. Methods: This population-based case-referent study used data from two nationwide case registers that are linked to the Swedish Medical Birth Registry and cover incident cases of type 1 diabetes in the 0-to 14-year (since 1 July 1977) and 15-to 34-year age groups (since 1 January 1983). Of the cases linked to the Medical Birth Registry, a total of 9,283 cases with onset before 15 years of age was recorded before 1 January 2003, and 1,610 cases were recorded with onset before 30 years of age and born after 1973 (together 95% of eligible cases). Multiple births and babies of diabetic mothers were excluded. Sexspecific birthweight by gestational week is expressed as multiples of the standard deviation (SDS) and adjusted for year of birth, maternal age and parity. Results: Cases with onset before 10 years of age (n=5,792) showed a significant linear trend in odds ratio (OR) by SDS of adjusted birthweight (OR by SDS: 0.062; 95% CI: 0.037-0.086; p<0.0001), while cases with onset at the age of 10-29 years showed no significant trend (OR by SDS: 0.004; 95% CI: −0.007 to 0.0014; p=0.22). Conclusions/interpretation: The association between type 1 diabetes risk and birthweight seems to be limited to cases with disease onset in younger years.