Originals

Diabetologia

, Volume 35, Issue 1, pp 70-76

Epidemiology of childhood diabetes mellitus in Finland — background of a nationwide study of Type 1 (insulin-dependent) diabetes mellitus

  • J. TuomilehtoAffiliated withDepartment of Epidemiology, National Public Health Institute
  • , R. LounamaaAffiliated withDepartment of Epidemiology, National Public Health Institute
  • , E. Tuomilehto-WolfAffiliated withDepartment of Epidemiology, National Public Health Institute
  • , A. ReunanenAffiliated withResearch Institute for Social Security, Social Insurance Institution
  • , E. VirtalaAffiliated withDepartment of Epidemiology, National Public Health Institute
  • , E. A. KaprioAffiliated withFirst Department of Paediatrics
  • , H. K. ÅkerblomAffiliated withSecond Department of Paediatrics, The Children's Hospital, University of Helsinki
  • , L. Toivanen
  • , A. Fagerlund
    • , M. Flittner
    • , B. Gustafsson
    • , A. Hakulinen
    • , L. Herva
    • , P. Hiltunen
    • , T. Huhtamäki
    • , N. -P. Huttunen
    • , T. Huupponen
    • , M. Hyttinen
    • , C. Häggqvist
    • , T. Joki
    • , R. Jokisalo
    • , S. Kallio
    • , U. Kaski
    • , M. Knip
    • , M. -L. Käär
    • , L. Laine
    • , J. Lappalainen
    • , J. Mäenpää
    • , A. -L. Mäkelä
    • , K. Niemi
    • , A. Niiranen
    • , A. Nuuja
    • , P. Ojajärvi
    • , T. Otonkoski
    • , K. Pihlajamäki
    • , S. Pöntynen
    • , J. Ranjantie
    • , J. Sankala
    • , J. Schumacher
    • , M. Sillanpää
    • , C. -H. Stråhlmann
    • , M. -R. Ståhlberg
    • , T. Uotila
    • , P. Varimo
    • , G. Wetterstrand
    • , M. Väre
    • , A. AroAffiliated withNational Public Health Institute
    • , H. HurmeAffiliated withPedagogic Faculty in Vaasa, Åbo Akademi
    • , H. HyötyAffiliated withInstitute of Biomedical Sciences, University of Tampere
    • , J. IlonenAffiliated withNational Public Health Institute
    • , J. KarjalainenAffiliated withDepartment of Pediatrics, University of Oulu
    • , R. LaPorteAffiliated withDepartment of Epidemiology, National Public Health InstituteDiabetes Research Center of Children's Hospital of Pittsburgh
    • , P. LeinikkiAffiliated withDepartment of Epidemiology, National Public Health InstituteNational Public Health Institute
    • , A. MiettinenAffiliated withDepartment of Epidemiology, National Public Health InstituteDepartment of Bacteriology and Immunology, University of Helsinki
    • , L. RäsänenAffiliated withDepartment of Epidemiology, National Public Health InstituteDepartment of Nutrition, University of Helsinki
    • , E. SavilahtiAffiliated withDepartment of Epidemiology, National Public Health InstituteChildren's Hospital, University of Helsinki
    • , S. M. VirtanenAffiliated withDepartment of Epidemiology, National Public Health InstituteDepartment of Nutrition, University of Helsinki

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Summary

A nationwide study of childhood Type 1 (insulin-dependent) diabetes mellitus was established in 1986 in Finland, the country with the highest incidence of this disease worldwide. The aim of the project called “Childhood Diabetes in Finland” is to evaluate the role of genetic, environmental and immunological factors and particularly the interaction between genetic and environmental factors in the development of Type 1 diabetes. From September 1986 to April 1989, 801 families with a newly-diagnosed child aged 14 years or younger at the time of diagnosis were invited to participate in this study. The vast majority of the families agreed to participate in the comprehensive investigations of the study. HLA genotypes and haplotypes were determined in 757 families (95%). Our study also incorporates a prospective family study among non-diabetic siblings aged 3–19 years, and two case-control studies among the youngonset cases of Type 1 diabetes. During 1987–1989, the overall incidence of Type 1 diabetes was about 35.2 per 100,000 per year. It was higher in boys (38.4) than in girls (32.2). There was no clear geographic variation in incidence among the 12 provinces of Finland. Of the 1,014 cases during these 3 years only six cases were diagnosed before their first birthday. The incidence was high already in the age group 1–4-years old: 33.2 in boys and 29.5 in girls. Of the 801 families 90 (11.2%) were multiple case families, of which 66 had a parent with Type 1 diabetes at the time of diagnosis of the proband. The prevalence of Type 1 diabetes in the parents of these newly-diagnosed diabetic children was higher in fathers (5.7%) than in mothers (2.6%).

Key words

Type 1 (insulin-dependent) diabetes mellitus epidemiology genetic-environmental interaction incidence familial occurrence