Increase in the Incidence of Type 1 Diabetes Mellitus in Children in Three Cities in Poland, 1987-1999

Abstract

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.

Incidence of type 1 diabetes mellitus in the 0- to 17-yr-old Israel population, 1997?2003

“…The incidence of type 1 diabetes mellitus (T1DM) is increasing in both industrialized and non‐industrialized countries (1–5). Reports from the EURODIAB TIGER Study Group for 1989–1998 show an overall annual increase of 3.2% in T1DM in children younger than 15 yr. Central‐Eastern Europe showed the highest increase, whereas no increase was evident in Sardinia and Northern Europe, except in Finland (5).…”

“…In Slovakia, the incidence rate of childhood diabetes rose from 6 per 100 000 in 1985 to 13.5 per 100 000 in 2000 (2). Similar trends were reported in Poland (3), Finland, and Baltic countries (4). Reports from the EURODIAB TIGER Study Group show an overall annual increase of 3.2% in T1DM in children younger than 15 yr (5).…”

“…An increasing incidence of T1DM has been reported in both industrialized and non‐industrialized countries during the past 20 yr (1–5). In Yorkshire, England, an average annual increase of 2.9% in incidence rates during 1978–2000 was reported for children aged 0–14 yr (1).…”

Changes in frequency of IDDM‐associated HLA DQB, CTLA4 and INS alleles

“…, 1987) and in 1996 exceeded 9/100 000 per year (Kretowski et al. , 2001; Dziatkowiak et al. , 2002).…”

“…For the last few decades, the incidence of type 1 diabetes has been increasing worldwide (Onkamo et al, 1999), as it has within Europe, particularly in centraleastern regions . The first register of diabetic patients in Midwest Poland, established for the period of 1970-1981 revealed an incidence rate of 3.5 ⁄ 100 000 -the number almost doubled for the same region within the following 2 years (Rewers et al, 1987) and in 1996 exceeded 9 ⁄ 100 000 per year (Kretowski et al, 2001;Dziatkowiak et al, 2002). The reasons for the sudden increase in the incidence rate remain unknown.…”