Explosive increase in type 1 diabetes predicted
Patterson CC, G Dahlquist GG, Gyürüs E, et
al: the EURODIAB Study Group. Incidence trends
for childhood type 1 diabetes in Europe during
1989—2003 and predicted new cases
2005—20: a multicentre prospective
registration study. The
Lancet, 2009 Early Online
Publication, 28 May 2009
doi:10.1016/S0140-6736(09)60568-7
Summary
Background
The incidence of type 1 diabetes in children
younger than 15 years is increasing. Prediction
of future incidence of this disease will enable
adequate fund allocation for delivery of care
to be planned. We aimed to establish 15-year
incidence trends for childhood type 1 diabetes
in European centres, and thereby predict the
future burden of childhood diabetes in
Europe.
Methods
20 population-based EURODIAB registers in 17
countries registered 29 311 new cases of type 1
diabetes, diagnosed in children before their
15th birthday during a 15-year period,
1989—2003. Age-specific log linear rates
of increase were estimated in five geographical
regions, and used in conjunction with published
incidence rates and population projections to
predict numbers of new cases throughout Europe
in 2005, 2010, 2015, and 2020.
Findings
Ascertainment was better than 90% in most
registers. All but two registers showed
significant yearly increases in incidence,
ranging from 0·6% to 9·3%. The overall annual
increase was 3·9% (95% CI 3·6—4·2), and
the increases in the age groups 0—4
years, 5—9 years, and 10—14 years
were 5·4% (4·8—6·1), 4·3%
(3·8—4·8), and 2·9% (2·5—3·3),
respectively. The number of new cases in Europe
in 2005 is estimated as 15 000, divided between
the 0—4 year, 5—9 year, and
10—14 year age-groups in the ratio 24%,
35%, and 41%, respectively. In 2020, the
predicted number of new cases is 24 400, with a
doubling in numbers in children younger than 5
years and a more even distribution across
age-groups than at present (29%, 37%, and 34%,
respectively). Prevalence under age 15 years is
predicted to rise from 94 000 in 2005, to 160
000 in 2020.
Interpretation
If present trends continue, doubling of new
cases of type 1 diabetes in European children
younger than 5 years is predicted between 2005
and 2020, and prevalent cases younger than 15
years will rise by 70%. Adequate health-care
resources to meet these children's needs should
be made available.
|
COMMENT: The
changes over time are so rapid, say the authors, that
they clearly cannot be because of genetic factors
alone. They discuss modern lifestyle habits as possible
contributory factors, such as increased weight and
height development and increased caesarean section
births. The higher increases are seen in Eastern
Europe, where lifestyle habits are also changing more
rapidly than in the richer European countries.
The researchers sya they
are uncertain about the precise causes for the increase
in incidence and earlier age of onset of type 1
diabetes. But they shouldn't be. See http://www.second-opinions.co.uk/diabetes-7.html.
What have been the major
environmental changes of the last quarter of a century?
The biggest one, most likely to affect diabetes and
obesity, is 'healthy eating' which was introduced in
the 1980s and has been aggressively promoted ever
since.
And, as Eastern European
countries have joined the EU and come under the
influence of Western European dietary paradigms, it is
not surprising that the consequent dramatic change of
diet should cause an equally dramatic increase in
'western' diseases such as diabetes.
Last updated 20 May 2009
|
"A great
book that shatters so many of the nutritional fantasies
and fads of the last twenty years. Read it and prolong
your life."
Clarissa Dickson Wright
"NH&WL
may be the best non-technical book on diet ever
written"
Joel Kauffman, PhD, Professor Emeritus, University of
the Sciences, Philadelphia, PA
- a completely new
kind of video and DVD.
"Must be
regarded as essential reading . . . informative and
thought-provoking." Dr Vyvyan Howard, MB. ChB.
PhD. FRCPath. University of Liverpool.
|
