title: Major increase in Type 1 diabetes: no support for the Accelerator Hypothesis.
abstract: BACKGROUND
  The Accelerator Hypothesis postulates that the apparent increase in incidence of Type 1 diabetes mellitus (T1DM) is related to an acceleration of disease onset by weight-related insulin resistance. Our diabetes clinic has experienced a major recent increase in newly diagnosed diabetes. The Accelerator Hypothesis predicts that this increase should be associated with younger age and increased body mass at diagnosis, with youngest children having the highest body mass index (BMI).
  
  
  OBJECTIVE
  To test the Accelerator Hypothesis in the context of the major increase in T1DM at our centre.
  
  
  METHODS
  Data from all young people diagnosed with T1DM between 1992 and 2003 were reviewed. Height and weight measurements from initial outpatient review were used to calculate BMI.
  
  
  RESULTS
  The mean increase in BMI standard deviation score (SDS) is 0.03 per year (P = 0.01). Age at diagnosis has also increased by a mean of 0.11 years annually (P = 0.003). There was no association between BMI SDS and age at diagnosis (P = 0.7). A significant difference in BMI SDS between age-banded subgroups was evident (P = 0.04); however, youngest children had the lowest SDS.
  
  
  CONCLUSIONS
  Our results do not support increased body mass as an accelerator of diabetes presentation.
authors.affiliation: Department of Endocrinology and Diabetes, Royal Children's Hospital and Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: O'Connell
authors.forename: S
authors.initials: S
authors.lastname: Donath
authors.forename: F J
authors.initials: FJ
authors.lastname: Cameron
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male