An increase in the prevalence of type 1 and 2 diabetes in children and adolescents: results from prescription data from a UK general practice database.
BACKGROUND
Increasing antidiabetic drugs use in youths has been reported in the USA, however there is a lack of epidemiological evidence in the UK. There is an increase in the prevalence of both type 1 and 2 diabetes, but precise estimates are difficult to obtain and as such are uninformative for future health services planning.


CONCLUSIONS
The prevalence of children receiving insulin and oral antidiabetic drugs has increased twofold and eightfold, respectively, between 1998 and 2005. The data reflect the prevalence of both type 1 and type 2 diabetes rapidly increase in recent years. The prevalence of antidiabetic drug use increases with increasing age, especially among those aged 12-18 years. Consideration needs to be given to the funding and design of future services for children and particularly adolescents with diabetes to take account of these epidemiological findings.


OBJECTIVE
Despite evidence of an increase in the incidence of both type 1 and type 2 diabetes in youths, there are few data on the prevalence of either type in children and adolescents. The aim of this study was to investigate the prevalence of childhood diabetes over an 8-year period in the UK.


METHODS
This was a retrospective cohort study that covered 8 years (January 1998 to December 2005) of UK IMS Disease Analyzer (IMS DA) data. The cohort comprised all children and adolescents aged 0-18 years who received at least one antidiabetic drug prescription during the study period. The prevalence of antidiabetic drug prescribing was used as a proxy for diabetes itself.


RESULTS
Data were available on 505 754 children aged 0-18 years and a total of 37 225 antidiabetic prescriptions were issued. Insulin use increased significantly from 1.08 per 1000 children [95% confidence interval (CI) 0.96, 1.20] in 1998 to 1.98 (95% CI 1.80, 2.10) in 2005 (P < 0.001), more markedly in those aged 12 and 18 years. The use of oral antidiabetic drugs for diabetes treatment rose significantly from 0.006 per 1000 children in 1998 (95% CI 0.0043, 0.017) to 0.05 (95% CI 0.025, 0.080) (P < 0.001) in 2005.


CONCLUSIONS
This study indicates a significant increase in prevalence on both type 1 and type 2 diabetes treatment in children and adolescents in the UK. Thus, this supporting evidence from other sources that the prevalence of childhood diabetes is rising rapidly. Further epidemiological studies are required to investigate the aetiology and risk factors.
Hsia
Yingfen
Y
Centre for Paediatric Pharmacy Research, The School of Pharmacy, University of London and The Institute of Child Health, University College London, London, UK.
Neubert
Antje C
AC
Rani
Fariz
F
Viner
Russell M
RM
Hindmarsh
Peter C
PC
Wong
Ian C K
IC
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005194:Family Practice; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology
D007004:Hypoglycemic Agents; D007328:Insulin