Incidence of and mortality from Type I diabetes in Taiwan from 1999 through 2010: a nationwide cohort study.
OBJECTIVE
To evaluate the secular trend in incidence of and mortality from Type 1 diabetes mellitus (T1DM) in Taiwan, 1999-2010.


METHODS
All 7,225 incident cases of T1DM were retrospectively retrieved from Taiwan's National Health Insurance Research Database from 1999 to 2010. Trend of bi-annual age- and sex-specific incidence rates of T1DM was calculated and tested with Poisson regression model. Standardized mortality ratios (SMRs) were calculated, using age-, sex-, and calendar years-specific mortality rates of the general population as the reference, to estimate the relative mortality risk of T1DM.


RESULTS
The number of male and female T1DM was 3,471 (48%) and 3,754 (52%), respectively. The annual number of incident T1DM increased from 543 in 1999 to 737 in 2010. The overall bi-annual incidence rate rose from 1999-00 to 2003-04 and mildly declined thereafter rose to 2009-10, with an insignificant trend (P = 0.489) over the study period. Regardless of gender, the higher age-specific incidence rate was noted in the younger groups (<30 years) and highest at <15 years. The incidence rates in younger groups were constantly higher in female population than in male one. The SMR from all causes was significantly increased at 3.00 (95% Confidence Interval (CI) 2.83-3.16) in patients with T1DM. The sex-specific SMR was 2.66 (95% CI 2.46-2.85) and 3.58 (95% CI 3.28-3.87) for male and female patients, respectively. For both sexes, the age-specific SMR peaked at 15-29 years.


CONCLUSIONS
Among T1DM patients in Taiwan, there were significant increasing trends in males and female aged <15 years. We also noted a significantly increased overall and sex-specific SMR from all causes in patients with TIDM which suggests a need for improvements in treatment and care of patients with T1DM.
Institute of Clinical Medicine, National Cheng-Kung University Hospital, National Cheng Kung University College of Medicine, Tainan, Taiwan ; Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Wei-Hung
WH
Lin
Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan ; Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Ming-Cheng
MC
Wang
Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Wei-Ming
WM
Wang
Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Deng-Chi
DC
Yang
Department of Anesthesiology, National Cheng Kung University Medical College, Tainan, Taiwan.
Chen-Fuh
CF
Lam
Institute of Clinical Medicine, National Cheng-Kung University Hospital, National Cheng Kung University College of Medicine, Tainan, Taiwan ; Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital and College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
Jun-Neng
JN
Roan
Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan ; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
Chung-Yi
CY
Li
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D002648:Child; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011159:Population Surveillance; D012737:Sex Factors; D055815:Young Adult