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Published in: Acta Diabetologica 6/2014

01-12-2014 | Original Article

Rapidly rising incidence of childhood type 1 diabetes in Chinese population: epidemiology in Shanghai during 1997–2011

Authors: Zhuhui Zhao, Chengjun Sun, Chunfang Wang, Pin Li, Wei Wang, Jun Ye, Xuefan Gu, Xiaodong Wang, Shuixian Shen, Dijing Zhi, Zhong Lu, Rong Ye, Ruoqian Cheng, Li Xi, Xiaojing Li, Zhangqian Zheng, Miaoying Zhang, Feihong Luo

Published in: Acta Diabetologica | Issue 6/2014

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Abstract

The aim of this study was to investigate incidence trend of childhood type 1 diabetes in Shanghai, a megalopolis in east China. We established a population-based retrospective registry for the disease in the city’s registered population during 1997–2011 and collected 622 incident type 1 diabetes in children aged 0–14 years. Standardized incidence rates and 95 % CI were estimated by applying the capture–recapture method and assuming Poisson distribution. Incidence trend was analyzed using the Poisson regression model. The mean annual incidence of childhood type 1 diabetes was 3.1 per 100,000 person-years. We did not observe significant difference in incidence between boys and girls. The incidence is unstable and had a mean annual increase 14.2 % per year during the studied period. A faster annual increase was observed in boys, warmer seasons, and in the outer regions of the city. If present trends continue, the number of new type 1 diabetes cases will double from 2016 to 2020, and prevalent cases will sextuple by 2025. Our results showed the incidence of childhood type 1 diabetes was rising rapidly in Shanghai. More studies are needed to analyze incidence changes in other regions of China for appropriate allocation of healthcare resources.
Literature
1.
go back to reference Gale EA (2005) Type 1 diabetes in the young: the harvest of sorrow goes on. Diabetologia 48:1435–1438PubMedCrossRef Gale EA (2005) Type 1 diabetes in the young: the harvest of sorrow goes on. Diabetologia 48:1435–1438PubMedCrossRef
2.
go back to reference WHO Diamond Project Group (1990) WHO Multinational Project for Childhood Diabetes. Diabetes Care 13:1062–1068CrossRef WHO Diamond Project Group (1990) WHO Multinational Project for Childhood Diabetes. Diabetes Care 13:1062–1068CrossRef
3.
go back to reference Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J (2000) Incidence of childhood type 1 diabetes worldwide: Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 23:1516–1526PubMedCrossRef Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J (2000) Incidence of childhood type 1 diabetes worldwide: Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 23:1516–1526PubMedCrossRef
4.
go back to reference National Bureau of Statistics of China (2011) Communiqué of the National Bureau of Statistics of People’s Republic of China on Major Figures of the 2010 Population Census (No. 1) National Bureau of Statistics of China (2011) Communiqué of the National Bureau of Statistics of People’s Republic of China on Major Figures of the 2010 Population Census (No. 1)
5.
go back to reference United Nations (2011) World population prospects: the 2010 revision volume I: comprehensive tables United Nations (2011) World population prospects: the 2010 revision volume I: comprehensive tables
6.
go back to reference DIAMOND Project Group (2006) Incidence and trends of childhood type 1 diabetes worldwide 1990–1999. Diabet Med 23:857–866CrossRef DIAMOND Project Group (2006) Incidence and trends of childhood type 1 diabetes worldwide 1990–1999. Diabet Med 23:857–866CrossRef
7.
go back to reference Patterson CC, Dahlquist GG, Gyurus E, Green A, Soltesz G (2009) Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 373:2027–2033PubMedCrossRef Patterson CC, Dahlquist GG, Gyurus E, Green A, Soltesz G (2009) Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 373:2027–2033PubMedCrossRef
8.
go back to reference Bruno G, Maule M, Biggeri A et al (2013) More than 20 years of registration of type 1 diabetes in Sardinian children: temporal variations of incidence with age, period of diagnosis, and year of birth. Diabetes 62:3542–3546PubMedCentralPubMedCrossRef Bruno G, Maule M, Biggeri A et al (2013) More than 20 years of registration of type 1 diabetes in Sardinian children: temporal variations of incidence with age, period of diagnosis, and year of birth. Diabetes 62:3542–3546PubMedCentralPubMedCrossRef
10.
go back to reference Fu H, Shen SX, Chen ZW et al (1994) Shanghai, China, has the lowest confirmed incidence of childhood diabetes in the world. Diabetes Care 17:1206–1208PubMedCrossRef Fu H, Shen SX, Chen ZW et al (1994) Shanghai, China, has the lowest confirmed incidence of childhood diabetes in the world. Diabetes Care 17:1206–1208PubMedCrossRef
11.
go back to reference Shen SX, Wang HB, Chen ZW et al (1996) The incidence of insulin-dependent diabetes mellitus in urban districts of Shanghai (1989–1993). J Pediatr Endocrinol Metab 9:469–473PubMed Shen SX, Wang HB, Chen ZW et al (1996) The incidence of insulin-dependent diabetes mellitus in urban districts of Shanghai (1989–1993). J Pediatr Endocrinol Metab 9:469–473PubMed
12.
go back to reference International Working Group for Disease Monitoring and Forecasting (1995) Capture–recapture and multiple-record systems estimation II: applications in human diseases. Am J Epidemiol 142:1059–1068 International Working Group for Disease Monitoring and Forecasting (1995) Capture–recapture and multiple-record systems estimation II: applications in human diseases. Am J Epidemiol 142:1059–1068
13.
go back to reference McCarty DJ, Tull ES, Moy CS, Kwoh CK, LaPorte RE (1993) Ascertainment corrected rates: applications of capture–recapture methods. Int J Epidemiol 22:559–565PubMedCrossRef McCarty DJ, Tull ES, Moy CS, Kwoh CK, LaPorte RE (1993) Ascertainment corrected rates: applications of capture–recapture methods. Int J Epidemiol 22:559–565PubMedCrossRef
14.
17.
go back to reference Karvonen M, Pitkaniemi M, Pitkaniemi J, Kohtamaki K, Tajima N, Tuomilehto J (1997) Sex difference in the incidence of insulin-dependent diabetes mellitus: an analysis of the recent epidemiological data. World Health Organization DIAMOND Project Group. Diabetes Metab Rev 13:275–291PubMedCrossRef Karvonen M, Pitkaniemi M, Pitkaniemi J, Kohtamaki K, Tajima N, Tuomilehto J (1997) Sex difference in the incidence of insulin-dependent diabetes mellitus: an analysis of the recent epidemiological data. World Health Organization DIAMOND Project Group. Diabetes Metab Rev 13:275–291PubMedCrossRef
18.
go back to reference Fourlanos S, Varney MD, Tait BD et al (2008) The rising incidence of type 1 diabetes is accounted for by cases with lower-risk human leukocyte antigen genotypes. Diabetes Care 31:1546–1549PubMedCentralPubMedCrossRef Fourlanos S, Varney MD, Tait BD et al (2008) The rising incidence of type 1 diabetes is accounted for by cases with lower-risk human leukocyte antigen genotypes. Diabetes Care 31:1546–1549PubMedCentralPubMedCrossRef
19.
go back to reference Wilkin TJ (2001) The accelerator hypothesis: weight gain as the missing link between type I and type II diabetes. Diabetologia 44:914–922PubMedCrossRef Wilkin TJ (2001) The accelerator hypothesis: weight gain as the missing link between type I and type II diabetes. Diabetologia 44:914–922PubMedCrossRef
20.
go back to reference EURODIAB Substudy 2 Study Group (2002) Rapid early growth is associated with increased risk of childhood type 1 diabetes in various European populations. Diabetes Care 25:1755–1760CrossRef EURODIAB Substudy 2 Study Group (2002) Rapid early growth is associated with increased risk of childhood type 1 diabetes in various European populations. Diabetes Care 25:1755–1760CrossRef
22.
go back to reference McKinney PA, Okasha M, Parslow RC et al (2000) Early social mixing and childhood type 1 diabetes mellitus: a case–control study in Yorkshire, UK. Diabet Med 17:236–242PubMedCrossRef McKinney PA, Okasha M, Parslow RC et al (2000) Early social mixing and childhood type 1 diabetes mellitus: a case–control study in Yorkshire, UK. Diabet Med 17:236–242PubMedCrossRef
23.
go back to reference Cardwell CR, Stene LC, Joner G et al (2008) Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia 51:726–735PubMedCrossRef Cardwell CR, Stene LC, Joner G et al (2008) Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia 51:726–735PubMedCrossRef
24.
go back to reference Patterson CC, Dahlquist G, Soltesz G, Green A (2001) Is childhood-onset type I diabetes a wealth-related disease? An ecological analysis of European incidence rates. Diabetologia 44(Suppl 3):B9–16PubMedCrossRef Patterson CC, Dahlquist G, Soltesz G, Green A (2001) Is childhood-onset type I diabetes a wealth-related disease? An ecological analysis of European incidence rates. Diabetologia 44(Suppl 3):B9–16PubMedCrossRef
25.
go back to reference Zhang XM, Wang HY, Luo YY, Ji LN (2009) HLA-DQ, DR allele polymorphism of type 1 diabetes in the Chinese population: a meta-analysis. Chin Med J 122:980–986PubMed Zhang XM, Wang HY, Luo YY, Ji LN (2009) HLA-DQ, DR allele polymorphism of type 1 diabetes in the Chinese population: a meta-analysis. Chin Med J 122:980–986PubMed
26.
go back to reference Ji CY, Chen TJ (2008) Secular changes in stature and body mass index for Chinese youth in sixteen major cities, 1950s–2005. Am J Hum Biol 20:530–537PubMedCrossRef Ji CY, Chen TJ (2008) Secular changes in stature and body mass index for Chinese youth in sixteen major cities, 1950s–2005. Am J Hum Biol 20:530–537PubMedCrossRef
27.
go back to reference Zhang M, Guo F, Tu Y et al (2012) Further increase of obesity prevalence in Chinese children and adolescents–cross-sectional data of two consecutive samples from the city of Shanghai from 2003 to 2008. Pediatr Diabetes 13:572–577PubMedCrossRef Zhang M, Guo F, Tu Y et al (2012) Further increase of obesity prevalence in Chinese children and adolescents–cross-sectional data of two consecutive samples from the city of Shanghai from 2003 to 2008. Pediatr Diabetes 13:572–577PubMedCrossRef
28.
go back to reference Yu Z, Han S, Chu J, Xu Z, Zhu C, Guo X (2012) Trends in overweight and obesity among children and adolescents in China from 1981 to 2010: a meta-analysis. PLoS ONE 7:e51949PubMedCentralPubMedCrossRef Yu Z, Han S, Chu J, Xu Z, Zhu C, Guo X (2012) Trends in overweight and obesity among children and adolescents in China from 1981 to 2010: a meta-analysis. PLoS ONE 7:e51949PubMedCentralPubMedCrossRef
29.
go back to reference Lumbiganon P, Laopaiboon M, Gulmezoglu AM et al (2010) Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet 375:490–499PubMedCrossRef Lumbiganon P, Laopaiboon M, Gulmezoglu AM et al (2010) Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet 375:490–499PubMedCrossRef
31.
go back to reference Cui L, Shi J (2012) Urbanization and its environmental effects in Shanghai, China. Urban Clim 2:1–15CrossRef Cui L, Shi J (2012) Urbanization and its environmental effects in Shanghai, China. Urban Clim 2:1–15CrossRef
32.
go back to reference Li J, Li C, Zhu F, Song C, Wu J (2013) Spatiotemporal pattern of urbanization in Shanghai, China between 1989 and 2005. Landsc Ecol 28:1545–1565CrossRef Li J, Li C, Zhu F, Song C, Wu J (2013) Spatiotemporal pattern of urbanization in Shanghai, China between 1989 and 2005. Landsc Ecol 28:1545–1565CrossRef
33.
go back to reference Cherubini V, Carle F, Gesuita R et al (1999) Large incidence variation of type I diabetes in central-southern Italy 1990–1995: lower risk in rural areas. Diabetologia 42:789–792PubMedCrossRef Cherubini V, Carle F, Gesuita R et al (1999) Large incidence variation of type I diabetes in central-southern Italy 1990–1995: lower risk in rural areas. Diabetologia 42:789–792PubMedCrossRef
34.
go back to reference Knip M, Veijola R, Virtanen SM, Hyoty H, Vaarala O, Akerblom HK (2005) Environmental triggers and determinants of type 1 diabetes. Diabetes 54(Suppl 2):S125–S136PubMedCrossRef Knip M, Veijola R, Virtanen SM, Hyoty H, Vaarala O, Akerblom HK (2005) Environmental triggers and determinants of type 1 diabetes. Diabetes 54(Suppl 2):S125–S136PubMedCrossRef
35.
go back to reference Kimpimaki T, Kupila A, Hamalainen AM et al (2001) The first signs of beta-cell autoimmunity appear in infancy in genetically susceptible children from the general population: the Finnish Type 1 Diabetes Prediction and Prevention Study. J Clin Endocrinol Metab 86:4782–4788PubMed Kimpimaki T, Kupila A, Hamalainen AM et al (2001) The first signs of beta-cell autoimmunity appear in infancy in genetically susceptible children from the general population: the Finnish Type 1 Diabetes Prediction and Prevention Study. J Clin Endocrinol Metab 86:4782–4788PubMed
37.
go back to reference Zeng M, Li YF, Wang XH et al (2012) Epidemiology of hand, foot, and mouth disease in children in Shanghai 2007–2010. Epidemiol Infect 140:1122–1130PubMedCrossRef Zeng M, Li YF, Wang XH et al (2012) Epidemiology of hand, foot, and mouth disease in children in Shanghai 2007–2010. Epidemiol Infect 140:1122–1130PubMedCrossRef
38.
40.
go back to reference Writing Group for the SEARCH for Diabetes in Youth Study Group, Dabelea D, Bell RA et al (2007) Incidence of diabetes in youth in the United States. JAMA 297:2716–2724PubMedCrossRef Writing Group for the SEARCH for Diabetes in Youth Study Group, Dabelea D, Bell RA et al (2007) Incidence of diabetes in youth in the United States. JAMA 297:2716–2724PubMedCrossRef
41.
go back to reference Yang Z, Long X, Shen J et al (2005) Epidemics of type 1 diabetes in China. Pediatr Diabetes 6:122–128PubMedCrossRef Yang Z, Long X, Shen J et al (2005) Epidemics of type 1 diabetes in China. Pediatr Diabetes 6:122–128PubMedCrossRef
42.
go back to reference Yang W, Lu J, Weng J et al (2010) Prevalence of diabetes among men and women in China. N Engl J Med 362:1090–1101PubMedCrossRef Yang W, Lu J, Weng J et al (2010) Prevalence of diabetes among men and women in China. N Engl J Med 362:1090–1101PubMedCrossRef
43.
go back to reference Xu Y, Wang L, He J et al (2013) Prevalence and control of diabetes in Chinese adults. J Am Med Assoc 310:948–959CrossRef Xu Y, Wang L, He J et al (2013) Prevalence and control of diabetes in Chinese adults. J Am Med Assoc 310:948–959CrossRef
Metadata
Title
Rapidly rising incidence of childhood type 1 diabetes in Chinese population: epidemiology in Shanghai during 1997–2011
Authors
Zhuhui Zhao
Chengjun Sun
Chunfang Wang
Pin Li
Wei Wang
Jun Ye
Xuefan Gu
Xiaodong Wang
Shuixian Shen
Dijing Zhi
Zhong Lu
Rong Ye
Ruoqian Cheng
Li Xi
Xiaojing Li
Zhangqian Zheng
Miaoying Zhang
Feihong Luo
Publication date
01-12-2014
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 6/2014
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-014-0590-2

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