Higher incidence of childhood-onset type 1 diabetes mellitus in remote areas: a UK regional small-area analysis

Abstract

Aims/hypothesis We investigated the association between the incidence of type 1 diabetes mellitus and remoteness (a proxy measure for exposure to infections) using recently developed techniques for statistical analysis of small-area data.

Changing geographical distribution of diabetes mellitus type 1 incidence in Austrian children 1989–2005

“…Low-population density or remoteness has been found to increase the risk for Type 1 diabetes for several populations [11,12], but there are other countries which observed a reduced risk in rural areas [15][16][17]. In this study we found a significant association with lower incidence for densely populated districts.…”

“…In several studies population density as well as body mass index (BMI) of newborns have been associated with incidence of Diabetes mellitus Type 1 [10,11,13,20]. Therefore we included population density (inhabitants/ square kilometre) as well as mean of the body mass index of newborns in each district in our model replacing the East-West trend.…”

“…Population density has been associated with incidence of Diabetes mellitus Type 1 in several studies [10][11][12][13][14][15][16][17][18]. Most investigations describe a higher risk in areas with lower population density.…”

“…Most investigations describe a higher risk in areas with lower population density. This sometimes is referred to an hygiene hypothesis [11,14]. In short, this hypothesis postulates that reduced exposure to infections may increase the risk for an abnormal immune response and thereby increases the risk of Diabetes mellitus Type 1.…”

¿El contexto geográfico importa en la mortalidad por diabetes mellitus? Tendencias espacio-temporales en Argentina, 1990-2012

“…La mayoría de los estudios dedicados a analizar la distribución espacial de la diabetes se han enfocado en la incidencia y prevalencia de la diabetes mellitus 1 12,13,14,15,16,17 , mientras que pocos estudios han analizado los patrones de distribución espacial de la enfermedad de la diabetes mellitus 2 18,19,20,21 . Green et al 19 demostraron que tasas altas de diabetes mellitus 2 se agrupaban significativamente en el espacio, de acuerdo con características étnicas, socioeconómicas, ambientales y de estilo de vida de la población de un área urbana de Canadá.…”