Skip to main content
Top
Published in: Diabetologia 3/2004

01-03-2004 | Article

The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children

Authors: Prof. K. O. Kyvik, L. Nystrom, F. Gorus, M. Songini, J. Oestman, C. Castell, A. Green, E. Guyrus, C. Ionescu-Tirgoviste, P. A. McKinney, D. Michalkova, R. Ostrauskas, N. T. Raymond

Published in: Diabetologia | Issue 3/2004

Login to get access

Abstract

Aims/hypothesis

This prospective study examined the epidemiology of Type 1 diabetes in young adults in Europe.

Methods

We ascertained incident cases of Type 1 diabetes in the 15 to 29 years (both inclusive) age group throughout Europe over a period of 2 years. Diabetes registries in nine countries, in which incidence rates for Type 1 diabetes in the 0 to 14 age group were available, took part. Incidence rates were estimated per 100000 person years and standardised for sex and age. Cumulative incidences per 1000 from birth to age 30 were estimated. Heterogeneity between centres was tested with a Poisson regression model.

Results

A total of 2112 diabetes cases were ascertained in 1996 and 1997, of which 61.4% were considered to be Type 1 diabetes. Completeness of ascertainment varied from 70 to 90%. Standardised incidence varied from 4.8 per 100000 person years to 13.4 per 100000 person years. The male–female ratio was estimated to be one or more, and in the 25 to 29 age group 1.5 or more in all countries. Cumulative incidences for males and females indicate that the former exceeds the latter from age 24. In the two centres with highest childhood incidence, this applied already from 14 years of age.

Conclusions/interpretation

The incidence of Type 1 diabetes in adults is lower than in children and the range of incidence is also reduced, with a less than threefold variation in adults, against an eightfold variation in children. There is a male excess in incidence, especially in the age group 25 to 29 years.
Literature
1.
go back to reference Karjalainen J, Salmela P, Ilonen J, Surcel HM, Knip M (1989) A comparison of childhood and adult type I diabetes mellitus. N Engl J Med 320:881–886CrossRefPubMed Karjalainen J, Salmela P, Ilonen J, Surcel HM, Knip M (1989) A comparison of childhood and adult type I diabetes mellitus. N Engl J Med 320:881–886CrossRefPubMed
2.
go back to reference Krolewski AS, Warram JH, Rand LI, Kahn CR (1987) Epidemiologic approach to the etiology of type I diabetes mellitus and its complications. N Engl J Med 317:1390–1398CrossRefPubMed Krolewski AS, Warram JH, Rand LI, Kahn CR (1987) Epidemiologic approach to the etiology of type I diabetes mellitus and its complications. N Engl J Med 317:1390–1398CrossRefPubMed
3.
go back to reference Cordell HJ, Todd JA (1995) Multifactorial inheritance in type 1 diabetes. Trends Genet 11:499–504CrossRefPubMed Cordell HJ, Todd JA (1995) Multifactorial inheritance in type 1 diabetes. Trends Genet 11:499–504CrossRefPubMed
4.
go back to reference Green A, Gale EA, Patterson CC (1992) Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURODIAB ACE Study. Lancet 339:905–909CrossRefPubMed Green A, Gale EA, Patterson CC (1992) Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURODIAB ACE Study. Lancet 339:905–909CrossRefPubMed
5.
go back to reference Green A, Patterson C (2001) Trends in the incidence of childhood-onset diabetes in Europe 1989–1998. The EURODIAB TIGER Study Group. Diabetologia 44 [Suppl]:B3–B8 Green A, Patterson C (2001) Trends in the incidence of childhood-onset diabetes in Europe 1989–1998. The EURODIAB TIGER Study Group. Diabetologia 44 [Suppl]:B3–B8
6.
go back to reference EURODIAB ACE Study Group (2000) Variation and trends in incidence of childhood diabetes in Europe. EURODIAB ACE Study Group. Lancet 355:873–876CrossRef EURODIAB ACE Study Group (2000) Variation and trends in incidence of childhood diabetes in Europe. EURODIAB ACE Study Group. Lancet 355:873–876CrossRef
7.
go back to reference Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, La Porte R, Tuomilehto J (2000) Incidence of childhood type 1 diabetes worldwide. The Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 23:1516–1526CrossRefPubMed Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, La Porte R, Tuomilehto J (2000) Incidence of childhood type 1 diabetes worldwide. The Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 23:1516–1526CrossRefPubMed
8.
go back to reference Dahlquist G, Mustonen L (2000) Analysis of 20 years of prospective registration of childhood onset diabetes time trends and birth cohort effects. Swedish Childhood Diabetes Study Group. Acta Paediatr 89:1231–1237CrossRefPubMed Dahlquist G, Mustonen L (2000) Analysis of 20 years of prospective registration of childhood onset diabetes time trends and birth cohort effects. Swedish Childhood Diabetes Study Group. Acta Paediatr 89:1231–1237CrossRefPubMed
9.
go back to reference Jarosz-Chobot P, Otto-Buczkowska E, Koehler E, Matlakiewicz E, Green A (2000) Increased trend of type 1 diabetes mellitus in children’s population (0–14 years) in Upper Silesia region (Poland). Med Sci Monit 6:573–580PubMed Jarosz-Chobot P, Otto-Buczkowska E, Koehler E, Matlakiewicz E, Green A (2000) Increased trend of type 1 diabetes mellitus in children’s population (0–14 years) in Upper Silesia region (Poland). Med Sci Monit 6:573–580PubMed
10.
go back to reference Gardner SG, Bingley PJ, Sawtell PA, Weeks S, Gale EA (1997) Rising incidence of insulin dependent diabetes in children aged under 5 years in the Oxford region: time trend analysis. The Bart’s-Oxford Study Group. BMJ 315:713–717CrossRefPubMedPubMedCentral Gardner SG, Bingley PJ, Sawtell PA, Weeks S, Gale EA (1997) Rising incidence of insulin dependent diabetes in children aged under 5 years in the Oxford region: time trend analysis. The Bart’s-Oxford Study Group. BMJ 315:713–717CrossRefPubMedPubMedCentral
11.
go back to reference Podar T, Solntsev A, Karvonen M et al. (2001) Increasing incidence of childhood-onset type 1 diabetes in 3 Baltic countries and Finland 1983–1998. Diabetologia 44 [Suppl]:B17–B20 Podar T, Solntsev A, Karvonen M et al. (2001) Increasing incidence of childhood-onset type 1 diabetes in 3 Baltic countries and Finland 1983–1998. Diabetologia 44 [Suppl]:B17–B20
12.
go back to reference Rangasami JJ, Greenwood DC, McSporran B, Smail PJ, Patterson CC, Waugh NR (1998) Childhood insulin dependent diabetes: Oxford may not be representative. BMJ 316:391–392CrossRefPubMedPubMedCentral Rangasami JJ, Greenwood DC, McSporran B, Smail PJ, Patterson CC, Waugh NR (1998) Childhood insulin dependent diabetes: Oxford may not be representative. BMJ 316:391–392CrossRefPubMedPubMedCentral
13.
go back to reference Rangasami JJ, Greenwood DC, McSporran B, Smail PJ, Patterson CC, Waugh NR (1997) Rising incidence of type 1 diabetes in Scottish children, 1984–93. The Scottish Study Group for the Care of Young Diabetics. Arch Dis Child 77:210–213CrossRefPubMedPubMedCentral Rangasami JJ, Greenwood DC, McSporran B, Smail PJ, Patterson CC, Waugh NR (1997) Rising incidence of type 1 diabetes in Scottish children, 1984–93. The Scottish Study Group for the Care of Young Diabetics. Arch Dis Child 77:210–213CrossRefPubMedPubMedCentral
14.
go back to reference Feltbower RG, McKinney PA, Parslow RC, Stephenson CR, Bodansky HJ (2003) Type 1 diabetes in Yorkshire, UK: time trends in 0–14 and 15–29-year-olds, age at onset and age-period-cohort modelling. Diabet Med 20:437–441CrossRefPubMed Feltbower RG, McKinney PA, Parslow RC, Stephenson CR, Bodansky HJ (2003) Type 1 diabetes in Yorkshire, UK: time trends in 0–14 and 15–29-year-olds, age at onset and age-period-cohort modelling. Diabet Med 20:437–441CrossRefPubMed
15.
go back to reference Lorenzen T, Pociot F, Hougaard P, Nerup J (1994) Long-Term risk of IDDM in first-degree relatives of patients with IDDM. Diabetologia 37:321–327CrossRefPubMed Lorenzen T, Pociot F, Hougaard P, Nerup J (1994) Long-Term risk of IDDM in first-degree relatives of patients with IDDM. Diabetologia 37:321–327CrossRefPubMed
16.
go back to reference Gorus FK, Vandewalle CL, Dorchy H, Crombrugge P van, Schuit FC, Pipeleers DG (1994) Influence of age on the associations among insulin autoantibodies, islet cell antibodies, and HLA DAQ1*0301-DQB1*0302 in siblings of patients with type 1 (insulin-dependent) diabetes mellitus. Belgian Diabetes Registry. J Clin Endocrinol Metab 78:1172–1178PubMed Gorus FK, Vandewalle CL, Dorchy H, Crombrugge P van, Schuit FC, Pipeleers DG (1994) Influence of age on the associations among insulin autoantibodies, islet cell antibodies, and HLA DAQ1*0301-DQB1*0302 in siblings of patients with type 1 (insulin-dependent) diabetes mellitus. Belgian Diabetes Registry. J Clin Endocrinol Metab 78:1172–1178PubMed
17.
go back to reference Gorus FK, Anselmo J, Keymeulen B (1993) Type 1 (insulin-dependent) diabetes mellitus: an autoimmune, predictable and preventable disease? Lessons from national registries and new challenges to clinical biology. Acta Clin Belg 48:96–108CrossRefPubMed Gorus FK, Anselmo J, Keymeulen B (1993) Type 1 (insulin-dependent) diabetes mellitus: an autoimmune, predictable and preventable disease? Lessons from national registries and new challenges to clinical biology. Acta Clin Belg 48:96–108CrossRefPubMed
18.
go back to reference Blohme G, Nystrom L, Arnqvist HJ et al. (1992) Male predominance of type 1 (insulin-dependent) diabetes mellitus in young adults: results from a 5-year prospective nationwide study of the 15–34-year age group in Sweden. Diabetologia 35:56–62CrossRefPubMed Blohme G, Nystrom L, Arnqvist HJ et al. (1992) Male predominance of type 1 (insulin-dependent) diabetes mellitus in young adults: results from a 5-year prospective nationwide study of the 15–34-year age group in Sweden. Diabetologia 35:56–62CrossRefPubMed
19.
go back to reference Bruno G, Merletti F, Vuolo A, Pisu E, Giorio M, Pagano G (1993) Sex differences in incidence of IDDM in age-group 15–29 yr. Higher risk in males in Province of Turin, Italy. Diabetes Care 16:133–136CrossRefPubMed Bruno G, Merletti F, Vuolo A, Pisu E, Giorio M, Pagano G (1993) Sex differences in incidence of IDDM in age-group 15–29 yr. Higher risk in males in Province of Turin, Italy. Diabetes Care 16:133–136CrossRefPubMed
20.
go back to reference Nystrom L, Dahlquist G, Ostman J et al. (1992) Risk of developing insulin-dependent diabetes mellitus (IDDM) before 35 years of age: indications of climatological determinants for age at onset. Int J Epidemiol 21:352–358CrossRefPubMed Nystrom L, Dahlquist G, Ostman J et al. (1992) Risk of developing insulin-dependent diabetes mellitus (IDDM) before 35 years of age: indications of climatological determinants for age at onset. Int J Epidemiol 21:352–358CrossRefPubMed
21.
go back to reference Vandewalle CL, Coeckelberghs MI, De Leeuw IH et al. (1997) Epidemiology, clinical aspects, and biology of IDDM patients under age 40 years. Comparison of data from Antwerp with complete ascertainment with data from Belgium with 40% ascertainment. The Belgian Diabetes Registry. Diabetes Care 20:1556–1561CrossRefPubMed Vandewalle CL, Coeckelberghs MI, De Leeuw IH et al. (1997) Epidemiology, clinical aspects, and biology of IDDM patients under age 40 years. Comparison of data from Antwerp with complete ascertainment with data from Belgium with 40% ascertainment. The Belgian Diabetes Registry. Diabetes Care 20:1556–1561CrossRefPubMed
22.
go back to reference Roglic G, Pavlic Renar I, Sestan-Crnek S et al. (1995) Incidence of IDDM during 1988–1992 in Zagreb, Croatia. Diabetologia 38:550–554CrossRefPubMed Roglic G, Pavlic Renar I, Sestan-Crnek S et al. (1995) Incidence of IDDM during 1988–1992 in Zagreb, Croatia. Diabetologia 38:550–554CrossRefPubMed
23.
go back to reference Goday A, Castell C, Tresserras R, Canela J, Taberner JL, Lloveras G (1992) Incidence of type 1 (insulin-dependent) diabetes mellitus in Catalonia, Spain. The Catalan Epidemiology Diabetes Study Group. Diabetologia 35:267–271CrossRefPubMed Goday A, Castell C, Tresserras R, Canela J, Taberner JL, Lloveras G (1992) Incidence of type 1 (insulin-dependent) diabetes mellitus in Catalonia, Spain. The Catalan Epidemiology Diabetes Study Group. Diabetologia 35:267–271CrossRefPubMed
24.
go back to reference Christau B, Kromann H, Christy M, Andersen OO, Nerup J (1979) Incidence of insulin-dependent diabetes mellitus (0–29 years at onset) in Denmark. Acta Med Scand [Suppl] 624:54–60 Christau B, Kromann H, Christy M, Andersen OO, Nerup J (1979) Incidence of insulin-dependent diabetes mellitus (0–29 years at onset) in Denmark. Acta Med Scand [Suppl] 624:54–60
25.
go back to reference Joner G, Sovik O (1991) The incidence of type 1 (insulin-dependent) diabetes mellitus 15–29 years in Norway 1978–1982. Diabetologia 34:271–274CrossRefPubMed Joner G, Sovik O (1991) The incidence of type 1 (insulin-dependent) diabetes mellitus 15–29 years in Norway 1978–1982. Diabetologia 34:271–274CrossRefPubMed
26.
go back to reference Bruno G, Merletti F, Pisu E, Pastore G, Marengo C, Pagano G (1990) Incidence of IDDM during 1984–1986 in population aged less than 30 yr. Residents of Turin, Italy. Diabetes Care 13:1051–1056CrossRefPubMed Bruno G, Merletti F, Pisu E, Pastore G, Marengo C, Pagano G (1990) Incidence of IDDM during 1984–1986 in population aged less than 30 yr. Residents of Turin, Italy. Diabetes Care 13:1051–1056CrossRefPubMed
27.
go back to reference Muntoni S, Songini M (1992) High incidence rate of IDDM in Sardinia. Sardinian Collaborative Group for Epidemiology of IDDM. Diabetes Care 15:1317–1322CrossRefPubMed Muntoni S, Songini M (1992) High incidence rate of IDDM in Sardinia. Sardinian Collaborative Group for Epidemiology of IDDM. Diabetes Care 15:1317–1322CrossRefPubMed
29.
go back to reference Hook EB, Regal RR (1992) The value of capture-recapture methods even for apparent exhaustive surveys. The need for adjustment for source of ascertainment intersection in attempted complete prevalence studies. Am J Epidemiol 135:1060–1067CrossRefPubMed Hook EB, Regal RR (1992) The value of capture-recapture methods even for apparent exhaustive surveys. The need for adjustment for source of ascertainment intersection in attempted complete prevalence studies. Am J Epidemiol 135:1060–1067CrossRefPubMed
30.
go back to reference Diem K, Lentner C (1970) Documenta Geigy Scientific Tables, 7th edn. Geigy, Basle Diem K, Lentner C (1970) Documenta Geigy Scientific Tables, 7th edn. Geigy, Basle
31.
go back to reference Weets I, Autreve J van, Auwera BJ van der et al. (2001) Male-to-female excess in diabetes diagnosed in early adulthood is not specific for the immune-mediated form nor is it HLA-DQ restricted: possible relation to increased body mass index. Diabetologia 44:40–47CrossRefPubMed Weets I, Autreve J van, Auwera BJ van der et al. (2001) Male-to-female excess in diabetes diagnosed in early adulthood is not specific for the immune-mediated form nor is it HLA-DQ restricted: possible relation to increased body mass index. Diabetologia 44:40–47CrossRefPubMed
32.
go back to reference Gorus FK (1997) Diabetes registries and early biological markers of insulin-dependent diabetes mellitus. Belgian Diabetes Registry. Diabetes Metab Rev 13:247–274CrossRefPubMed Gorus FK (1997) Diabetes registries and early biological markers of insulin-dependent diabetes mellitus. Belgian Diabetes Registry. Diabetes Metab Rev 13:247–274CrossRefPubMed
33.
go back to reference Arnqvist HJ, Littorin B, Nystrom L et al. (1993) Difficulties in classifying diabetes at presentation in the young adult. Diabet Med 10:606–613CrossRefPubMed Arnqvist HJ, Littorin B, Nystrom L et al. (1993) Difficulties in classifying diabetes at presentation in the young adult. Diabet Med 10:606–613CrossRefPubMed
34.
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 13:275–291CrossRefPubMed 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 13:275–291CrossRefPubMed
35.
go back to reference Cucca F, Goy JV, Kawaguchi Y et al. (1998) A male-female bias in type 1 diabetes and linkage to chromosome Xp in MHC HLA-DR3-positive patients. Nat Genet 19:301–302CrossRefPubMed Cucca F, Goy JV, Kawaguchi Y et al. (1998) A male-female bias in type 1 diabetes and linkage to chromosome Xp in MHC HLA-DR3-positive patients. Nat Genet 19:301–302CrossRefPubMed
Metadata
Title
The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children
Authors
Prof. K. O. Kyvik
L. Nystrom
F. Gorus
M. Songini
J. Oestman
C. Castell
A. Green
E. Guyrus
C. Ionescu-Tirgoviste
P. A. McKinney
D. Michalkova
R. Ostrauskas
N. T. Raymond
Publication date
01-03-2004
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 3/2004
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-004-1331-9

Other articles of this Issue 3/2004

Diabetologia 3/2004 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.