The Rise of Childhood Type 1 Diabetes in the 20th Century

Abstract

The incidence of childhood type 1 diabetes increased worldwide in the closing decades of the 20th century, but the origins of this increase are poorly documented. A search through the early literature revealed a number of useful but neglected sources, particularly in Scandinavia. While these do not meet the exacting standards of more recent surveys, tentative conclusions can be drawn concerning long-term changes in the demography of the disease. Childhood type 1 diabetes was rare but well recognized before the introduction of insulin. Low incidence and prevalence rates were recorded in several countries over the period 1920 -1950, and one carefully performed study showed no change in childhood incidence over the period 1925-1955. An almost simultaneous upturn was documented in several countries around the mid-century. The overall pattern since then is one of linear increase, with evidence of a plateau in some high-incidence populations and of a catch-up phenomenon in some low-incidence areas. Steep rises in the age-group under 5 years have been recorded recently. The disease process underlying type 1 diabetes has changed over time and continues to evolve. Understanding why and how this produced the pandemic of childhood diabetes would be an important step toward reversing it. Diabetes 51:3353-3361, 2002

Vitamin D deficiency in early life accelerates Type 1 diabetes in non-obese diabetic mice

“…Although vitamin D supplements are advised in many countries, the application is far from strictly controlled and many times, these supplements are omitted or administered irregularly. Nutritional rickets that has never been completely eradicated in some countries and may be reappearing in industrialised countries [23] could be one of the factors contributing to the higher incidence of Type 1 diabetes in the past two decades [24]. A recent Finnish epidemiological study [17] has shown a clear association between overt rickets in the first year of life in this genetically high-risk population and the development of diabetes in later life.…”

Inhibition of type 1 diabetes in filaria‐infected non‐obese diabetic mice is associated with a T helper type 2 shift and induction of FoxP3+ regulatory T cells

“…6 Experimentally, a number of helminth parasites, including the trematode Schistosoma mansoni and the nematodes Heligmosomoides polygyrus and Trichinella spiralis, prevent the onset or suppress the severity of type 1 diabetes in non-obese diabetic (NOD) mice, [12][13][14] experimental autoimmune encephalitis 15 and experimental colitis. [16][17][18] A clinical trial demonstrated that oral administration of porcine whipworm eggs improves symptoms in patients with inflammatory bowel disease.…”

“…[1][2][3] The prevalence of type 1 diabetes and other autoimmune diseases has increased dramatically over the past few decades. [4][5][6] An analysis of 37 epidemiological studies conducted from 1960 to 1996 reports that there has been an increase in the incidence of type 1 diabetes worldwide of 3% per year over that time period, and that by the year 2010 the incidence of type 1 diabetes may be as high as 50/100 000 persons in some developed countries. 7 While genetic factors may play a role in susceptibility to type 1 diabetes, it is probable that the dramatic worldwide increase in type 1 diabetes prevalence is the result of environmental factors.…”

Continued increase in the incidence of childhood Type 1 diabetes in a population-based Australian sample (1985?2002)

“…A significant increase in the incidence of Type 1 diabetes over the past few decades has been reported worldwide [1,2,3,4]. estimated population of 1.9 million.…”