title: Rapid increase in the incidence of type 1 diabetes in Polish children from 1989 to 2004, and predictions for 2010 to 2025.
abstract: OBJECTIVE
  We analysed the temporal changes in the incidence of childhood type 1 diabetes and its demographic determinants in Poland from 1989 to 2004, validating the model with data from 1970 to 1989. We also estimated a predictive model of the trends in childhood diabetes incidence for the near future.
  
  
  METHODS
  Children under 15 years with newly diagnosed type 1 diabetes mellitus and drawn from seven regional registries in Poland were ascertained prospectively using the Epidemiology and Prevention of Diabetes study (EURODIAB) criteria. The type 1 diabetes incidence rates (IRs) were analysed in dependency of age, sex, seasonality, geographical region and population density. Time trends in IR were modelled using several approaches.
  
  
  RESULTS
  The average incidence, standardised by age and sex, for 1989 to 2004 was 10.2 per 100,000 persons per year and increased from 5.4 to 17.7. No difference was found between boys and girls, or between urban and rural regions. In children above 4 years, IR was significantly higher in the population of northern Poland than in that of the country's southern part, as well as in the autumn-winter season, this finding being independent of child sex. Based on the trend model obtained, almost 1,600 Polish children aged 0 to 14 years are expected to develop type 1 diabetes in 2010, rising to more than 4,800 in 2025. The estimates suggest at least a fourfold increase of IR between 2005 and 2025, with the highest dynamics of this increment in younger children.
  
  
  CONCLUSIONS
  These estimates show that Poland will have to face a twofold higher increase in childhood type 1 diabetes than predicted for the whole European population. The dramatic increase could have real downstream effects on Poland's healthcare system.
authors.affiliation: Department of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, Medykow 16 Str., 40-752, Katowice, Poland. pjarosz-chobot@sum.edu.pl
authors.forename: P
authors.initials: P
authors.lastname: Jarosz-Chobot
authors.forename: J
authors.initials: J
authors.lastname: Polanska
authors.forename: A
authors.initials: A
authors.lastname: Szadkowska
authors.forename: A
authors.initials: A
authors.lastname: Kretowski
authors.forename: E
authors.initials: E
authors.lastname: Bandurska-Stankiewicz
authors.forename: M
authors.initials: M
authors.lastname: Ciechanowska
authors.forename: G
authors.initials: G
authors.lastname: Deja
authors.forename: M
authors.initials: M
authors.lastname: Mysliwiec
authors.forename: J
authors.initials: J
authors.lastname: Peczynska
authors.forename: J
authors.initials: J
authors.lastname: Rutkowska
authors.forename: A
authors.initials: A
authors.lastname: Sobel-Maruniak
authors.forename: P
authors.initials: P
authors.lastname: Fichna
authors.forename: A
authors.initials: A
authors.lastname: Chobot
authors.forename: M
authors.initials: M
authors.lastname: Rewers
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011044:Poland / Q000453:epidemiology; D017678:Sex Distribution