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01-05-2009 | Original Paper

Incidence of diabetes mellitus among children of Italian migrants substantiates the role of genetic factors in the pathogenesis of type 1 diabetes

Authors: Stefan Ehehalt, Pavle Popovic, Sergio Muntoni, Sandro Muntoni, Andre Willasch, Regine Hub, Michael B. Ranke, Andreas Neu, for the DIARY Group Baden-Wuerttemberg

Published in: European Journal of Pediatrics | Issue 5/2009

Abstract

To investigate the role of genetic and environmental factors in the pathogenesis of type 1 diabetes mellitus (T1D), we carried out a study in Germany aimed at comparing the prevalence and incidence of T1D among children of migrant Italians from high-risk (Sardinia) and low-risk (continental Italy) regions versus German children. Children from Italy were identified by the “Baden-Wuerttemberg (BW) Diabetes Incidence Registry”, which registered 4017 newly diagnosed T1D patients, aged 0–14 years, between 1987 and 2003. Data relating to T1D children from Sardinia were elicited from more than 2000 questionnaires. Our findings were: (1) T1D is more frequent among German children than among children of Italian migrants [incidence rate (IR) 14.8/100,000/year, 95% confidence interval (CI) 14.4–15.4 vs. IR 10.8/100,000/year, 95% CI 8.2–13.6); (2) the incidence of T1D among Italian children residing in Germany is similar to that of Italian children in the home country (IR 10.8/100,000/year, 95% CI 8.2–13.6 vs. 8.4/100,000/year, 95% CI 7.9–8.9); (3) the prevalence of T1D among Sardinian children is higher than that among German children (0.11%, 95% CI 0.11–0.12) independent of the place where the Sardinian children are living (Sardinian children in Germany 2.3%, 95% CI 0.5–6.5 vs. Sardinian children in Sardinia 0.30%, 95% CI 0.27–0.32). Conclusion: Children from high- and low-risk areas of Italy have incidence rates of T1D that are closer to those of their native regions than to those of German children, indicating that genetic factors play a predominant role in the pathogenesis of T1D.

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The DIAMOND Project Group (2006) Incidence and trends of childhood Type 1 diabetes worldwide 1990–1999. Diabet Med 23(8):857–866. doi:10.1111/j.1464-5491.2006.01925.x CrossRef

Muntoni S, Cocco P, Aru G, Cucca F (2000) Nutritional factors and worldwide incidence of childhood type 1 diabetes. Am J Clin Nutr 71(6):1525–1529PubMed

Muntoni S, Muntoni S (2006) Epidemiological association between some dietary habits and the increasing incidence of type 1 diabetes worldwide. Ann Nutr Metab 50(1):11–19. doi:10.1159/000089559 PubMedCrossRef

Neu A, Willasch A, Ehehalt S, Kehrer M, Hub R, Ranke MB (2001) Diabetes incidence in children of different nationalities: an epidemiological approach to the pathogenesis of diabetes. Diabetologia 44[Suppl 3]:21–B 26CrossRef

Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J, for the Diabetes Mondiale (DIAMOND) Project Group (2000) Incidence of the childhood Type 1 diabetes worldwide. Diabetes Care 23:1516–1626. doi:10.2337/diacare.23.10.1516 PubMedCrossRef

Green A, Gale EAM, Patterson CC (1992) Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURDIAB ACE study. Lancet 339:905–909. doi:10.1016/0140-6736(92)90938-Y PubMedCrossRef

Neu A, Ehehalt S, Willasch A, Kehrer M, Hub R, Ranke MB (2001) Rising incidence of Type 1 diabetes in Germany. 12-Year trend analysis in children 0–14 years of age. Diabetes Care 24(4):785–786. doi:10.2337/diacare.24.4.785 PubMedCrossRef

LaPorte RE, McCarty DJ, Tull ES, Tajima N (1992) Counting birds bees and NCDs. Lancet 339:494–495. doi:10.1016/0140-6736(92)91103-F PubMedCrossRef

LaPorte RE, McCarty DJ, Bruno G, Tajima N, Baba S (1993) Counting diabetes in the next millennium: application of capture-recapture technology. Diabetes Care 16:528–534. doi:10.2337/diacare.16.2.528 PubMedCrossRef

10.

Carle F, Gesuita R, Bruno G, Coppa GV, Falorni A, Lorini R, Martinucci ME, Pozzilli P, Prisco F, Songini M, Tenconi MT, Cherubini V, for the RIDI Study Group (2004) Diabetes Incidence in 0- to 14-Year Age-Group in Italy. Diabetes Care 27(12):2790–2796. doi:10.2337/diacare.27.12.2790 PubMedCrossRef

11.

Casu A, Pascutto CI, Bernardinelli L, Songini M, the Sardinian IDDM Epidemiology Study Group (2004) Type 1 diabetes among Sardinian children is increasing. Diabetes Care 17(7):1623–1629. doi:10.2337/diacare.27.7.1623 CrossRef

12.

Gordis L (2001) Epidemiologie. Kilian, Marburg

13.

Beauftragte der Bundesregierung für Ausländerfragen (1999) Migrationsbericht 1999. Zu- und Abwanderung nach und aus Deutschland. BBfA, Bonn

14.

Bruno G, Pagano G, Faggiano F, De Salvia A, Merletti F (2000) Effect of Sardinian heritage on risk and age at onset of type 1 diabetes: a demographic case-control study of Sardinian migrants. Int J Epidemiol 29:532–535. doi:10.1093/ije/29.3.532 PubMedCrossRef

15.

Kaprio J, Tuomilehto J, Koskenvuo M, Romanov K, Reunanen A, Eriksson J et al (1992) Concordance for type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes mellitus in a population-based cohort of twins in Finland. Diabetologia 35:1060–1067. doi:10.1007/BF02221682 PubMedCrossRef

16.

Kyvik KO, Green A, Beck-Nielsen H (1995) Concordance rates of insulin dependent diabetes mellitus: a population based study of young Danish twins. Br Med J 311:913–917

17.

Muntoni S, Fonte MT, Stoduto S, Marietti G, Bizzarri C, Crinò A et al (1997) Incidence of insulin-dependent diabetes mellitus among Sardinian-heritage children born in the Lazio region, Italy. Lancet 349(9046):160–162. doi:10.1016/S0140-6736(96)04241-9 PubMedCrossRef

18.

Muntoni S, Muntoni S (1999) New insights into the epidemiology of Type 1 diabetes in Mediterranean countries. Diabetes Metab Res Rev 15:133–140. doi:10.1002/(SICI)1520-7560(199903/04)15:2<133::AID-DMRR20>3.0.CO;2-V PubMedCrossRef

19.

Patrick SL, Kadohiro JK, Waxman SH, Curb JD, Orchard TJ, Dorman JS et al (1997) IDDM incidence in a multiracial population. The Hawaii IDDM Registry, 1980–1990. Diabetes Care 20(6):983–987. doi:10.2337/diacare.20.6.983 PubMedCrossRef

20.

Weintrob N, Sprecher E, Israel S, Pinhas-Hamiel O, Kwon OJ, Bloch K et al (2001) Type 1 diabetes environmental factors and correspondence analysis of HLA class II genes in the Yemenite Jewish community in Israel. Diabetes Care 24(4):650–653. doi:10.2337/diacare.24.4.650 PubMedCrossRef

21.

Bodansky HJ, Staines A, Stephenson C, Haigh D, Cartwright R (1992) Evidence for an environmental effect in the aetiology of insulin dependent diabetes in a transmigratory population. Br Med J 304:1020–1022CrossRef

22.

Elliott RB (1992) Epidemiology of diabetes in Polynesia and New Zealand. In: Lévy-Marchal C, Czernichow P (eds) Epidemiology and etiology of insulin-dependent diabetes in the young. Pediatric and adolescent endocrinology, vol 21. Karger, Basel, pp 66–71

23.

Pundziote-Lyckå A, Dahlquist G, Nyström L, Arnqvist H, Björke E, Blohme G, Swedish Childhood Diabetes Study Group (2002) The incidence of Type I diabetes has not increased but shifted to a younger age at diagnosis in the 0–34 years group in Sweden 1983–1998. Diabetologia 45:783–792. doi:10.1007/s00125-002-0845-2 CrossRef

24.

Weets I, De Leeuw IH, Du Caju MVL, Rooman R, Keymeulen B, Mathieu C, The Belgian Diabetes Registry (2002) The incidence of Type 1 diabetes in the age group 0–39 years has not increased in Antwerp (Belgium) between 1989 and 2000. Diabetes Care 25:840–846, doi:10.2337/diacare.25.5.840 PubMedCrossRef

Title: Incidence of diabetes mellitus among children of Italian migrants substantiates the role of genetic factors in the pathogenesis of type 1 diabetes
Authors: Stefan Ehehalt
Pavle Popovic
Sergio Muntoni
Sandro Muntoni
Andre Willasch
Regine Hub
Michael B. Ranke
Andreas Neu
for the DIARY Group Baden-Wuerttemberg
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: European Journal of Pediatrics / Issue 5/2009
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-008-0808-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Incidence of diabetes mellitus among children of Italian migrants substantiates the role of genetic factors in the pathogenesis of type 1 diabetes

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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