Elsevier

The Journal of Pediatrics

Volume 161, Issue 4, October 2012, Pages 652-657.e1
The Journal of Pediatrics

Original Article
The Increasing Onset of Type 1 Diabetes in Children

https://doi.org/10.1016/j.jpeds.2012.03.061Get rights and content

Objective

To identify trends in the recent onset of type 1 diabetes (T1D) in Colorado youth seen at the Barbara Davis Center (BDC) and compare these changes over time.

Study design

A retrospective chart review was performed of patients ages 0-20 years at diagnosis of T1D and type 2 diabetes who were seen at the BDC, were living within Colorado at diagnosis, and were seen within 1 month of diagnosis between 1996 and 2010. The review included age of onset, sex, month and season of onset, islet autoantibodies, diabetes type, hemoglobin A1c level, and body mass index.

Results

Newly diagnosed youth with diabetes (n = 2841) were seen at the BDC between 1996 and 2010. Of these, 2686 (94.4%) had T1D. The number of newly diagnosed youth increased over the 15 years by 5.71% per year when adjusted for population (P < .0001). When analyzed in 5-year periods, the average number of new onset T1D cases, age-adjusted to the population, increased by 9.46% per year from 1996-2000 to 2001-2005. The increase was only 4.86% per year from 2001-2005 to 2006-2010. Islet autoimmune markers appeared to correlate with changes in T1D new onset cases.

Conclusion

T1D in youth increased significantly from the late 1990s-2005 and has increased at a lesser rate more recently. Data suggests that even though T1D has increased in all age groups, the greatest increase was in the 5-9 year age category.

Section snippets

Methods

A retrospective chart review was performed of patients ages 0-20 years who were seen at the BDC for new onset diabetes within 1 month of diagnosis from 1996-2010 inclusive. This protocol was approved by the Colorado Multiple Institutional Review Board. Youth from states other than Colorado (∼600) were excluded from analysis as there is no information concerning the percentage of cases referred to the BDC. Factors analyzed included age of onset, month and season of onset, sex, islet

Results

Overall, 2692 newly diagnosed youth from Colorado with T1D were seen at the BDC between 1996 and 2010 (54% male) (Table I). There was an average of 111 new cases per year in 1996-2000, 184 cases per year from 2001-2005, and 243 cases per year in the final 5-year period. This is 13.53 new cases seen at the BDC per 100 000 Colorado children and youth in this time period. Across all ages, the number of youth <20 years seen at the BDC increased over the 15 years by 5.71% per year when adjusted for

Discussion

This study confirms that the onset of T1D in youth has continued to increase in recent years, although the rate of increase in our population was not as great in the most recent 5-year period, 2006-2010, compared with 2000-2005. There have been consistent reports of an increased incidence over the past several decades,1, 2, 3, 4, 9, 11, 14, 21 though the current study includes more recent years than in previous reports. The European Diabetes Aetiology of Childhood Diabetes on an Epidemiological

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    Supported by the Pediatric Clinical Translational Research Center (grant RR00069) and the University of Arizona College of Medicine-Tucson Medical Student Research Program (NIH T35 HL007479). The authors declare no conflicts of interest.

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