title: Comparison of anti-diabetic drug prescribing in children and adolescents in seven European countries.
abstract: OBJECTIVE
  The aim of this study was to compare the prevalence of diabetes in children across seven European countries, when using prescribing of anti-diabetics as a proxy for diabetes. A secondary aim was to assess the potential for collaboration between countries using different databases in diabetes research.
  
  
  METHODS
  Data were obtained from population-based clinical databases in seven European countries. The study population comprised children aged 0-18 years. Prescriptions were categorized using the Anatomic Therapeutic Chemical (ATC) classification. The one-year user prevalence in 2008 was calculated for each country and stratified by age and sex.
  
  
  RESULTS
  We studied a total of 5.8 million children and adolescents. The prevalence of insulin prescribing varied between 1.1 and 3.5 per 1000 population, being highest in Sweden and lowest in Italy. In all countries, novel insulin analogues were the most commonly used insulins. The prevalence of oral anti-diabetic prescribing ranged from 0.08 per 1000 individuals in Sweden and Germany to 0.21 per 1000 population in the UK. Overall, the absolute number of oral anti-diabetic users was very low.
  
  
  CONCLUSIONS
  This study shows that there is a varying frequency of type 1 diabetes in children and adolescents across Europe. We also demonstrated that it is possible to obtain similar information from different clinical databases within Europe, which would allow continuous monitoring of type 1 diabetes. Owing to the lack of indications in most of the databases, this approach is less suitable for type 2 diabetes.
authors.affiliation: Centre for Paediatric Pharmacy Research, The School of Pharmacy, University of London and The Institute of Child Health, University College London, London, UK. antje.neubert@uk-erlangen.de
authors.forename: Antje
authors.initials: A
authors.lastname: Neubert
authors.forename: Yingfen
authors.initials: Y
authors.lastname: Hsia
authors.forename: Lolkje T W
authors.initials: LT
authors.lastname: de Jong-van den Berg
authors.forename: Katrin
authors.initials: K
authors.lastname: Janhsen
authors.forename: Gerd
authors.initials: G
authors.lastname: Glaeske
authors.forename: Kari
authors.initials: K
authors.lastname: Furu
authors.forename: Helle
authors.initials: H
authors.lastname: Kieler
authors.forename: Mette
authors.initials: M
authors.lastname: Nørgaard
authors.forename: Antonio
authors.initials: A
authors.lastname: Clavenna
authors.forename: Ian C K
authors.initials: IC
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007223:Infant; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin