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The incidence of Type 1 diabetes has not increased but shifted to a younger age at diagnosis in the 0-34 years group in Sweden 1983 to 1998
Umeå University, Faculty of Medicine, Clinical Sciences.
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2002 In: Diabetologia, ISSN 0012-186X, Vol. 45, no 6, 783-791 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2002. Vol. 45, no 6, 783-791 p.
Identifiers
URN: urn:nbn:se:umu:diva-2386OAI: oai:DiVA.org:umu-2386DiVA: diva2:140353
Available from: 2003-10-01 Created: 2003-10-01Bibliographically approved
In thesis
1. Incidence trends and environmental determinants of type 1 diabetes in Lithuania and Sweden
Open this publication in new window or tab >>Incidence trends and environmental determinants of type 1 diabetes in Lithuania and Sweden
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Variation of diabetes incidence over time in countries with different incidence levels and socio-economic conditions, and in an age span beyond the childhood years, may give clues for diabetes causes.

Materials: Data from prospective type 1 diabetes registers in Sweden and Lithuania in children (0-14 years) and young adults (15-34 and 15-39 years, respectively). Number of infections recorded in health care booklets (117 cases; 270 controls); interview about the dietary intake one-year before the diagnosis and routinely recorded growth data (99 cases; 180 controls).

Results: The incidence of type 1 diabetes in Sweden and Lithuania differed most in the younger age groups, 28.9 and 7.5/100,000/year in 0-14-year group, respectively. During 1983-2000 incidence increased in 0-14-year old children in both countries, but the pattern of change differed. During 1983-1998 the incidence increased in Swedish children, but tended to decrease in young adults, with no increase in the age group below 35 years, indicating that the increase of childhood diabetes may be due to a shift towards a younger age at diagnosis. Within a low-incidence country Lithuania there was an urban-rural gradient of incidence, especially in the younger age groups, that seemed to follow poverty distribution: incidence in the 0-39-year group was 7.1, 9.0 and 8.8/100,000/year in rural areas, towns and cities, respectively, p<0.001.

Exposure to one or more non-specific infection during the first half-year of life reduced diabetes risk: odds ratios (95%-CI) in 0-14 and 5-14-year groups were (0.60; 0.37-0.98) and (0.47; 0.26-0.87), respectively. Higher energy intake and weight-for-age were independent diabetes risk factors: odds ratios for medium and high levels of energy were 1.33 (0.52-3.42) and 5.23 (1.67-16.38), and for weight-for-age 3.20 (1.30-7.88) and 3.09 (1.16-8.22), respectively. High intake of carbohydrates, disaccharides and sucrose in particular, increased diabetes risk independently of the high intake of energy.

Conclusion: Environmental factors associated with socio-economic conditions in childhood may be important for the occurrence of type 1 diabetes. Lack of exposure to microbial antigens early in life, higher intake of energy and more rapid growth may contribute to the increase of childhood-onset diabetes observed in many countries.

Place, publisher, year, edition, pages
Umeå: Umeå university, 2003. 70 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 853
Keyword
Pediatrics, type 1 diabetes mellitus, epidemiology, childhood, incidence, secular trend, case-control study, risk factors, infections, energy, weight, Pediatrik
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-114 (URN)91-7305-519-0 (ISBN)
Public defence
2003-10-03, Major Groove, 6L (mikrobiologi), Umeå, 09:00
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Available from: 2003-10-01 Created: 2003-10-01 Last updated: 2012-08-08Bibliographically approved

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