Trends in childhood type 1 diabetes incidence in Europe during 1989-2008: evidence of non-uniformity over time in rates of increase.
OBJECTIVE
The aim of the study was to describe 20-year incidence trends for childhood type 1 diabetes in 23 EURODIAB centres and compare rates of increase in the first (1989-1998) and second (1999-2008) halves of the period.


METHODS
All registers operate in geographically defined regions and are based on a clinical diagnosis. Completeness of registration is assessed by capture-recapture methodology. Twenty-three centres in 19 countries registered 49,969 new cases of type 1 diabetes in individuals diagnosed before their 15th birthday during the period studied.


RESULTS
Ascertainment exceeded 90% in most registers. During the 20-year period, all but one register showed statistically significant changes in incidence, with rates universally increasing. When estimated separately for the first and second halves of the period, the median rates of increase were similar: 3.4% per annum and 3.3% per annum, respectively. However, rates of increase differed significantly between the first half and the second half for nine of the 21 registers with adequate coverage of both periods; five registers showed significantly higher rates of increase in the first half, and four significantly higher rates in the second half.


CONCLUSIONS
The incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3-4% per annum, but the increase is not necessarily uniform, showing periods of less rapid and more rapid increase in incidence in some registers. This pattern of change suggests that important risk exposures differ over time in different European countries. Further time trend analysis and comparison of the patterns in defined regions is warranted.
Centre for Public Health, Queen's University Belfast, Institute of Clinical Science Block B, Grosvenor Road, Belfast, BT12 6BJ, UK. c.patterson@qub.ac.uk
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CC
Patterson
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Gyürüs
J
J
Rosenbauer
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O
Cinek
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A
Neu
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Schober
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Parslow
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Joner
J
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Svensson
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Castell
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Bingley
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Schoenle
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Jarosz-Chobot
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Urbonaité
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Rothe
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Krzisnik
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Ionescu-Tirgoviste
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Weets
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Kocova
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Stipancic
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Samardzic
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de Beaufort
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Green
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Dahlquist
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Soltész
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002669:Child Welfare; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006285:Health Planning; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate