Incidence of Type 1 Diabetes among Children and Adolescents in Italy between 2009 and 2013: The Role of a Regional Childhood Diabetes Registry.
BACKGROUND
Surveillance represents a key strategy to control type 1 diabetes mellitus (T1DM). In Italy, national data are missing. This study aimed at evaluating the incidence of T1DM in subjects <18 year olds in Apulia (a large southeastern region, about 4,000,000 inhabitants) and assessing the sensitivity of the regional Registry of Childhood-Onset Diabetes (RCOD) in the 2009-2013 period.


METHODS
We performed a retrospective study matching records from regional Hospital Discharge Registry (HDR), User Fee Exempt Registry (UFER), and Drugs Prescription Registry (DPR) and calculated T1DM incidence; completeness of each data source was also estimated. In order to assess the RCOD sensitivity we compared cases from the registry to those extracted from HDR-UFER-DPR matching.


RESULTS
During 2009-2013, a total of 917 cases (about 184/year) in at least one of the three sources and an annual incidence of 25.2 per 100,000 were recorded, lower in infant, increasing with age and peaked in 5- to 9-year-olds. The completeness of DPR was 78.7%, higher than that of UFER (64.3%) and of HDR (59.6%). The RCOD's sensitivity was 39.05% (360/922; 95% CI: 34.01%-44.09%).


CONCLUSIONS
Apulia appeared as a high-incidence region. A full, active involvement of physicians working in paediatric diabetes clinics would be desirable to improve the RCOD performance.
Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 70121 Foggia, Italy.
F
F
Fortunato
Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 70121 Foggia, Italy.
M G
MG
Cappelli
Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 70121 Foggia, Italy.
M M
MM
Vece
Taranto Local Health Unit, Viale Virgilio 31, Taranto, 74121 Puglia, Italy.
G
G
Caputi
Pediatric Department "B. Trambusti", Policlinico Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy.
M
M
Delvecchio
Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 70121 Foggia, Italy.
R
R
Prato
Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 70121 Foggia, Italy.
D
D
Martinelli
Pediatric Department, "Vito Fazzi" Hospital, Piazzetta Muratore, 73100 Lecce, Italy; Pediatric Department, "F. Ferrari" Hospital, Via F. Ferrari 1, Casarano, 73042 Lecce, Italy; Department of Biomedical Sciences and Human Oncology, Policlinico Hospital, Giovanni XXIII Children's Hospital, Via Amendola 207, 70126 Bari, Italy; Pediatric Department, "Ospedali Riuniti" Policlinico Hospital, Viale Pinto 1, 70122 Foggia, Italy; Pediatric Department, "Dario Camberlingo"Hospital, Viale M. delle Grazie, Francavilla Fontana, 72021 Brindisi, Italy; Pediatric Department, "T. Maselli" Hospital, Viale 2 Giugno, San Severo, 71016 Foggia, Italy; Pediatric Department, "Di Summa-Perrino" Hospital, S.S. 7 per Mesagne, 72100 Brindisi, Italy; Pediatric Department, "G. Panico" Hospital, Via S. Pio X 4, Tricase, 73039 Lecce, Italy; Department of Metabolic Diseases, Clinical Genetics and Diabetology, Policlinico Hospital, Giovanni XXIII Children's Hospital, Via Amendola 207, 70126 Bari, Italy.
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors