Trends in Incidence Rates during 1999-2008 and Prevalence in 2008 of Childhood Type 1 Diabetes Mellitus in GERMANY – Model-Based National Estimates

Abstract

AimsTo estimate the national incidence rate and trend of type 1 diabetes (T1DM) in Germany from 1999 to 2008 and the national prevalence in 2008 in the age group 0–14 years.MethodsData were taken from a nationwide registry for incident cases of T1DM in the ages 0–4 years and 3 regional registries (North-Rhine-Westphalia, Baden-Wuerttemberg and Saxony) for incident cases of T1DM in the ages 0–14 years covering 41% of the child population in Germany. The degree of ascertainment was ≥ 97% in all registries. Incident and prevalent cases were grouped by region, sex, age (0–4, 5–9, 10–14 years), and, for incident data, additionally by two 5-year periods (1999–2003, 2004–2008). Poisson regression models were fitted to the data to derive national estimates of incidence rate trends and prevalence in the age groups 5–9, 10–14 and 0–14 years. We used direct age-standardization.ResultsThe estimated national incidence rate in 0-14-year-olds increased significantly by 18.1% (95%CI: 11.6–25.0%, p<0.001) from 1999–2003 to 2004–2008, independent of sex, corresponding to an average annual increase of 3.4% (95%-CI: 2.2–4.6%). The overall incidence rate was estimated at 22.9 per 100,000 person-years and we identified a within-country west-east-gradient previously unknown. The national prevalence in the ages 0–14 years on 31/12/2008 was estimated to be 148.1 per 100,000 persons.ConclusionsThe national incidence rate of childhood T1DM in Germany is higher than in many other countries around the world. Importantly, the estimated trend of the incidence rate confirms the international data of a global increase of T1DM incidences.

Needle-Free and Needle-Based Growth Hormone Therapy in Children: A Pooled Analysis of Three Long-Term Observational Studies

“…With regard to diabetes, only 1 case of type 1 diabetes was reported among the 1,595 patients of the safety cohort during the 22-year observational period. Based on an estimated national incidence rate of 22.9/100,000 person-years in German children aged 0–14 years [49], no increased risk of developing diabetes type 1 under GH therapy was identified in our study.…”

No change in type 2 diabetes prevalence in children and adolescents over 10 years: Update of a population-based survey in South Germany

“…Reports on T2D prevalence in childhood and adolescence, however, may refer to groups as follows: 0 to 14 years, 0 to 20 years, 10 to 20 years, or 6 to 15 years, thus rendering comparisons difficult. In spite of this, there is no doubt that the prevalence of T2D in South Germany remains far behind that of type 1 diabetes in the same area reported to be 132.6 (95% CI: 127.2‐138.3) per 100 000 in patients 0 to 14 years …”

The proportion of familial cases of type 1 diabetes is increasing simultaneously with the disease incidence: Eighteen years of the Israeli Pediatric Diabetes Registry

“…The incidence of type 1 diabetes (T1D) among children and adolescents is rising worldwide . Epidemiological studies have found an annual increase in T1D incidence of 1.5% to 2.4% in various areas of the United States and Canada, 3.3% to 5.9% in various European countries, 4.4% to 5.6% in Asia, and 3.8% in Australia . In a multicenter prospective study that included 20 population‐based registries from 17 countries in Europe (EURODIAB study group), all but 2 registries showed a significant rise in annual incidence ranging from 0.6% to 9.3% .…”