At a glance
|Type 1 diabetes (0-14 years)||
|Total child population (billions)||
|Number of children with type 1 diabetes||
|Type 1 diabetes prevalence (%)||
|Annual increase of incidence (%)||
|Estimated number of newly-diagnosed cases per year||
The incidence of childhood onset diabetes is increasing in many countries in the world. There are clear indications of geographic differences in trends but the overall annual increase is estimated at around 3% 1 2 3 . Some 70,000 children worldwide are expected to develop type 1 diabetes annually. There is some indication that incidence is increasing more steeply in some of the low prevalence countries such as those in Central and Eastern Europe. Moreover, several European studies have suggested that, in relative terms, increases are greatest in young children 4 5 6 .
The predominant cause of hyperglycaemia in type 1 diabetes is an autoimmune destruction of the beta cells leading to absolute dependence on insulin treatment and a high rate of complications typically occurring at relatively young ages (see section on ‘What is Diabetes?’).
Although the cumulative incidence of diabetic nephropathy (kidney disease) has fallen over the last decades in dedicated centres, this trend is by no means universal. Recent observations have shown, however, that those who survive microvascular complications still face the prospect of accelerated atherosclerosis.
In addition, unsatisfactory metabolic control in children can result in stunted growth and exposure to severe hypoglycaemia may affect neurodevelopment so that in children who develop type 1 diabetes very early in age, structural brain abnormalities and impaired cognitive function 7 8 may occur making the everyday treatment specifically important. Therefore type 1 diabetes places a particularly heavy burden on the individual, the family and the health services.
Children are more sensitive to a lack of insulin than adults and are at higher risk of a rapid and dramatic development of diabetic ketoacidosis. It has also been shown that in developed countries there is still significant excess mortality from ketoacidosis 9 10 11 12 among children with type 1 diabetes, and mortality in undiagnosed diabetes is probably a large but hidden problem in the global perspective.
1.Onkamo,P. Vaananen,S. Karvonen,M. Tuomilehto,J. Worldwide increase in incidence of type 1 diabetes--the analysis of the data on published incidence trends. Diabetologia.1999; 42(12): 1395-1403
2.EURODIAB ACE Study Group Variation and trends in incidence of childhood diabetes in Europe.. Lancet.2000; 355(9207): 873-876
3.Green,A. Patterson,C.C. Trends in the incidence of childhood-onset diabetes in Europe 1989-1998. Diabetologia.2001; 44 Suppl 3: B3-B8
4.Tuomilehto,J. Virtala,E. Karvonen,M. Lounamaa,R. Pitkaniemi,J. Reunanen,A. Tuomilehto-Wolf,E. Toivanen,L. Increase in incidence of insulin-dependent diabetes mellitus among children in Finland. Int J Epidemiol.1995; 24(5): 984-992
5.Gardner,S.G. Bingley,P.J. Sawtell,P.A. Weeks,S. Gale,E.A. Rising incidence of insulin dependent diabetes in children aged under 5 years in the Oxford region: time trend analysis. The Bart’s-Oxford Study Group. BMJ.1997; 315(7110): 713-717
6.Dahlquist,G. Mustonen,L. Analysis of 20 years of prospective registration of childhood onset diabetes time trends and birth cohort effects. Swedish Childhood Diabetes Study Group. Acta Paediatr.2000; 89(10): 1231-1237
7.Ryan,C. Vega,A. Drash,A. Cognitive deficits in adolescents who developed diabetes early in life. Pediatrics.1985; 75(5): 921-927
8.Ferguson,S.C. Blane,A. Wardlaw,J. Frier,B.M. Perros,P. McCrimmon,R.J. Deary,I.J. Influence of an early-onset age of type 1 diabetes on cerebral structure and cognitive function. Diabetes Care.2005; 28(6): 1431-1437
9.Schober,E. Schneider,U. Friedl,H.P. Unsinn,K. Early mortality in childhood diabetes in Austria--a population based cohort study. Eur J Pediatr.1997; 156(1): 15-17
10.Lipton,R. Good,G. Mikhailov,T. Freels,S. Donoghue,E. Ethnic differences in mortality from insulin-dependent diabetes mellitus among people less than 25 years of age. Pediatrics.1999; 103(5 Pt 1): 952-956
11.Edge,J.A. Ford-Adams,M.E. Dunger,D.B. Causes of death in children with insulin dependent diabetes 1990-96. Arch Dis Child.1999; 81(4): 318-323
12.Dahlquist,G. Kallen,B. Mortality in childhood-onset type 1 diabetes: a population-based study. Diabetes Care.2005; 28(10): 2384-2387