Article

Time trends in the incidence of type 1 diabetes in Finnish children: A cohort study

Diabetes Unit, Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland.
The Lancet (Impact Factor: 45.22). 05/2008; 371(9626):1777-82. DOI: 10.1016/S0140-6736(08)60765-5
Source: PubMed

ABSTRACT

Finland has the highest incidence of type 1 diabetes worldwide, reaching 40 per 100,000 people per year in the 1990s. Our aim was to assess the temporal trend in type 1 diabetes incidence since 2000 in Finnish children aged younger than 15 years and to predict the number of cases of type 1 diabetes in the future.
Children with newly diagnosed type 1 diabetes in Finland who were listed on the National Public Health Institute diabetes register, Central Drug Register, and Hospital Discharge Register in 1980-2005 were included in a cohort study. We excluded patients with type 2 diabetes and diabetes occurring secondary to other conditions, such as steroid use, Down's syndrome, and congenital malformations of pancreas.
10,737 children-5816 boys and 4921 girls-were diagnosed with type 1 diabetes before 15 years of age during 1980-2005. The average age-standardised incidence was 42.9 per 100,000 per year (95% CI 42.6-44.3) during this period, increasing from 31.4 per 100,000 per year in 1980 to 64.2 per 100,000 per year in 2005. The age-specific rates per 100,000 per year were 31.0, 50.5, and 50.6 at ages 0-4 years, 5-9 years, and 10-14-years, respectively. We noted a significant non-linear component to the time trend (p<0.0003). In children aged 0-4 years, the increase was largest, at 4.7% more affected every year. The overall boy-to-girl ratio of incidence was 1.1; at the age of 13 years, it was 1.7 (1.4-2.0). The predicted cumulative number of new cases with type 1 diabetes before 15 years of age between 2006 and 2020 was about 10 800.
The incidence of type 1 diabetes in Finnish children is increasing even faster than before. The number of new cases diagnosed at or before 14 years of age will double in the next 15 years and the age of onset will be younger (0-4 years).

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    • "Although type 1 diabetes can be diagnosed at any age, it is one of the most common chronic diseases of childhood. Its prevalence increases between the ages 5 and 7 years or near puberty [1]. "

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    • "Type 1 diabetes (T1D) is one of the most common chronic diseases with childhood onset, and the disease has increased two-to fivefold over the past half century by as yet unknown means [1] [2]. It was interpreted that if present trend continues, the prevalence of children with the disease in Europe will increase with 50% within year 2020 and with 70% for those less than 5 years of age [3]. "
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    ABSTRACT: Type 1 diabetes (T1D) is one of the most common chronic diseases with childhood onset, and the disease has increased two- to fivefold over the past half century by as yet unknown means. T1D occurs when the body’s immune system turns against itself so that, in a very specific and targeted way, it destroys the pancreatic β-cells. T1D results from poorly defined interactions between susceptibility genes and environmental determinants. In contrast to the rapid progress in finding T1D genes, identification and confirmation of environmental determinants remain a formidable challenge. This review article will focus on factors which have to be evaluated and decision to take before starting a new prospective cohort study. Considering all the large ongoing prospective studies, new and more conclusive data than that obtained so far should instead come from international collaboration on the ongoing cohort studies.
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    • "Since the 11th century researchers have been trying to clarify the bonds between DM and male fertility, describing DM as " a collapse of sexual functions " . In the last few years, the deleterious effects of DM on male fertility have become a matter of continuous debate due to its rapidly increasing incidence and the fact that the first diagnosis is taking place in increasingly younger individuals (Harjutsalo et al., 2008; Lavizzo-Mourey, 2007). So, the notion that DM is usually an elderly's disease has been quickly disregarded. "
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