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Epidemiology/Health Services Research
Incidence and seasonality of type 1 diabetes: a population-based 3-year cohort study using the National Database in Japan
  1. Yuichi Nishioka1,2,
  2. Tatsuya Noda1,
  3. Sadanori Okada2,
  4. Tomoya Myojin1,
  5. Shinichiro Kubo1,
  6. Tsuneyuki Higashino3,
  7. Hitoshi Ishii2,
  8. Tomoaki Imamura1
  1. 1Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Nara, Japan
  2. 2Department of Diabetes and Endocrinology, Nara Medical University, Kashihara, Nara, Japan
  3. 3Healthcare and Wellness Division, Mitsubishi Research Institute, Inc, Tokyo, Japan
  1. Correspondence to Dr Tatsuya Noda; noda{at}naramed-u.ac.jp

Abstract

Introduction To investigate the incidence of type 1 diabetes by age group (0–19, 20–39, 40–59, ≥60 years) in Japan and whether there is seasonality in this incidence.

Research design and methods The incidence of type 1 diabetes from September 2014 to August 2017 was estimated using 2013–2018 data from the National Database of Health Insurance Claims and Specific Health Check-ups of Japan. The incidence rate was analyzed using Tango’s Index and the self-controlled case series method.

Results Overall, 10 400 of the 79 175 553 included individuals were diagnosed with type 1 diabetes. The incidence of type 1 diabetes from September 2014 to August 2017 was 4.42/100 000 person-years. The incidence rates for men aged 0–19, 20–39, 40–59, and ≥60 years were 3.94, 5.57, 5.70, and 3.48, respectively. Among women, the incidence rates for the same age ranges were 5.22, 4.83, 4.99, and 3.31, respectively. Tango’s index showed that the incidence rate of type 1 diabetes was significantly associated with seasons among those aged 0–19 years. Further, the self-controlled case series method showed a significant interaction between age and season, with the incidence of type 1 diabetes being higher in spring for patients younger than 20 years of age.

Conclusions In Japan, men aged 40–59 years and women aged 0–19 years are the groups with the highest incidence of type 1 diabetes. Further, the incidence of younger-onset diabetes in Japan was higher in spring (from March to May).

  • insulin-deficient type 1 diabetes
  • clinical epidemiology
  • administrative data
  • incidence
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2020-001262

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    Footnotes

    • Contributors YN conducted the study design, analysis, and discussion. SO evaluated the results from the viewpoint of a clinician. TN provided advice on the study design and discussed the findings from the viewpoint of an epidemiologist. TM, SK, and TH performed the initial NDB analysis and provided technical advice. HI evaluated the results from the viewpoint of a clinician. TI provided advice on the study design and discussed the findings from the viewpoint of public health. Guarantor: YN.

    • Funding The present study was supported by JSPS KAKENHI Grant Number JP18K17390 and JP18H04126.

    • Competing interests YN reports receiving consultant fees from Novo Nordisk. SO reports receiving lecturer’s fees from Novo Nordisk, Mitsubishi Tanabe, Sumitomo Dainippon, MSD, Bayer, Eli Lilly, Boehringer Ingelheim, Ono, AstraZeneca, Sanofi, Takeda, and ARKRAY. HI reports receiving lecture fees and consultant fees from Takeda, Eli Lilly Japan, Sanofi, Merck & Co., Astellas, Mitsubishi Tanabe, Daiichi Sankyo, Ono, AstraZeneca, Taisho Toyama, Shionogi, Kowa, Boehringer Ingelheim, Novo Nordisk, Sumitomo Dainippon, and Kyowa Hakko Kirin. No other potential conflicts of interest relevant to this article are reported.

    • Patient consent for publication Obtained.

    • Ethics approval The study was approved by the Ethics Committee of Nara Medical University (1123–5).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available. Guidelines do not allow access to NDB except for those permitted.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.