Incidence of Type 1 Diabetes among Children and Adolescents in Italy between 2009 and 2013: The Role of a Regional Childhood Diabetes Registry

Abstract

Background. Surveillance represents a key strategy to control type 1 diabetes mellitus (T1DM). In Italy, national data are missing. This study aimed at evaluating the incidence of T1DM in subjects <18 year olds in Apulia (a large southeastern region, about 4,000,000 inhabitants) and assessing the sensitivity of the regional Registry of Childhood-Onset Diabetes (RCOD) in the 2009–2013 period. Methods. We performed a retrospective study matching records from regional Hospital Discharge Registry (HDR), User Fee Exempt Registry (UFER), and Drugs Prescription Registry (DPR) and calculated T1DM incidence; completeness of each data source was also estimated. In order to assess the RCOD sensitivity we compared cases from the registry to those extracted from HDR-UFER-DPR matching. Results. During 2009–2013, a total of 917 cases (about 184/year) in at least one of the three sources and an annual incidence of 25.2 per 100,000 were recorded, lower in infant, increasing with age and peaked in 5- to 9-year-olds. The completeness of DPR was 78.7%, higher than that of UFER (64.3%) and of HDR (59.6%). The RCOD's sensitivity was 39.05% (360/922; 95% CI: 34.01%–44.09%). Conclusions. Apulia appeared as a high-incidence region. A full, active involvement of physicians working in paediatric diabetes clinics would be desirable to improve the RCOD performance.

Updated 24‐year trend of Type 1 diabetes incidence in children in Poland reveals a sinusoidal pattern and sustained increase

“…Our results support our observation concerning the north/ south gradient [5]. An increase in Type 1 diabetes incidence when moving north from the equator has also been described in multi-country studies [5,7], although exceptions, such as recent findings from Spain and Italy, are known [28,30]. In additionally, although there was no difference in mean incidence rate between rural and urban regions, the population density factor did impact the trend model and this impact was slightly stronger than in the former model [5].…”

Changes in the incidence and prevalence of type 1 and type 2 diabetes among 2 million children and adolescents in Hungary between 2001 and 2016 – a nationwide population-based study

“…However, the current study shows a slower in-crease in the incidence rate of T1DM as compared with the former study (mean annual rate of 2.5% vs. 4.4%), although the previous study covered a substantially younger age group (0-14 years). The incidence data and its rising trend of T1DM in the current study are comparable to the findings of recent publications from the US [15,30,31], Australia [21] and Europe [32][33][34][35]. However, in some countries a flattened [11,12] or a sinusoidal pattern [22] of T1DM incidence is observed instead of an increase.…”

Cyclical variation in the incidence of childhood‐onset type 1 diabetes during 40 years in Navarra (Spain)

“…By age group, the highest incidence in Navarre is observed in the 10 to 14 age group, as in most of the countries; however, countries like Finland Italy,Estonia,, and some autonomous communities of Spain, have described peak incidence in the 5 to 9 age group. At follow‐up, in Navarre, an increase in the three age groups can be observed, increasing as the group age increases.…”

“…By age group, the highest incidence in Navarre is observed in the 10 to 14 age group, as in most of the countries; 10,17,25 however, countries like Finland 16 Italy, 26 Estonia, 27 , and some autonomous communities of Spain, have described peak incidence in the 5 to 9 age group.…”