, Volume 44, Supplement 3, pp B9–B16 | Cite as

Is childhood-onset Type I diabetes a wealth-related disease? An ecological analysis of European incidence rates

  • C. C. Patterson
  • G. Dahlquist
  • G. Soltész
  • A. Green
  • on behalf of the EURODIAB ACE Study Group



To describe the epidemiology of childhood-onset Type I (insulin-dependent) diabetes mellitus in Europe, the EURODIAB collaborative group established prospective, geographically-defined registers of children diagnosed under 15 years of age. A total of 16362 cases were registered by 44 centres during the period 1989–1994. The registers cover a population of approximately 28 million children with most European countries represented.


In most centres a primary and a secondary source of ascertainment were used so that the completeness of registration could be assessed by the capture-recapture method. Ecological correlation and regression analyses were used to study the relationship between incidence and various environmental, health and economic indicators.


The standardised average annual incidence rate during the period 1989–94 ranged from 3.2 cases per 100 000 person-years in the Former Yugoslavian Republic of Macedonia to 40.2 cases per 100 000 person-years in Finland. Indicators of national prosperity such as infant mortality (r = –0.64) and gross domestic product (r = 0.58) were most strongly and significantly correlated with incidence rate and previously-reported associations with milk consumption (r = 0.58), coffee consumption (r = 0.51) and latitude (r = 0.40) were also observed.


The wide variation in childhood Type I diabetes incidence rates within Europe could be partially explained by indicators of national prosperity. These indicators could reflect differences in environmental risk factors such as nutrition or lifestyle that are important in determining a country's incidence rate. [Diabetologia (2001) 44 [Suppl 3]: B 9–B 16]

Keywords Type I diabetes mellitus, epidemiology, geographical variation, incidence, risk factors, ecological analysis, gross domestic product. 

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • C. C. Patterson
    • 1
  • G. Dahlquist
    • 2
  • G. Soltész
    • 3
  • A. Green
    • 4
  • on behalf of the EURODIAB ACE Study Group
  1. 1.Department of Epidemiology and Public Health, Queen's University Belfast, Northern IrelandIE
  2. 2.Department of Clinical Science, Paediatrics University of Umeå, SwedenSE
  3. 3.Department of Paediatrics, University of Pećs, HungaryHU
  4. 4.Department of Epidemiology and Social Medicine, University of Aarhus, DenmarkDK

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