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Epidemiology of childhood IDDM in Northern Ireland 1989–1994: Low incidence in areas with highest population density and most household crowding

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Summary

During the period 1989–1994, 462 cases of insulin-dependent diabetes mellitus were registered among children from Northern Ireland aged under 15 years. The estimated completeness of the register was 98.8% (95% confidence interval (CI) 97.7%, 99.9%). A standardised rate of 19.6 (95% CI 17.8, 21.4) per 100 000 person years was obtained, placing Northern Ireland near the top of the range of published incidence in the United Kingdom, with a rate close to that reported for Scotland. In an analysis based on 217 postcode sectors, areas with a high population density and the most material deprivation were observed to have the lowest incidence rates. After inclusion of population density in a Poisson regression analysis, the component of deprivation which was found to be most significant was household crowding. Relative to children living in areas of low population density, there was a reduced risk for children in medium (relative incidence 0.85 (95% confidence limits CI 0.67,1.09)) and high (0.62 (95% CI 0.48,0.80)) population density areas. Similarly, relative to children living in areas with low levels of household crowding, there was a reduced risk for children in medium (relative incidence 0.73 (95% CI 0.58,0.93)) and high (0.67 (95%CI 0.53,0.83)) levels of household crowding. Tests for space-time clustering at diagnosis and at birth were negative. A possible explanation for the differences in incidence rate observed in this study is that exposure to infections very early in childhood is a protective factor. Later infections may act as either initiators or promoters of diabetes, but the absence of space-time clustering suggests that no single specific infectious agent is responsible.

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Abbreviations

IDDM:

Insulin-dependent diabetes mellitus

CI:

confidence interval

SIR:

standardised incidence ratio

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Authors and Affiliations

  1. Department of Epidemiology and Public Health, The Queen's University of Belfast, Royal Victoria Hospital, Grosvenor Road, BT12 6BJ, Belfast, UK

    C. C. Patterson

  2. Department of Child Health, The Queen's University of Belfast, Belfast, Northern Ireland, UK

    D. J. Carson

  3. Sir George E. Clark Metabolic Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK

    D. R. Hadden

Authors
  1. C. C. Patterson
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  2. D. J. Carson
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  3. D. R. Hadden
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The Northern Ireland Diabetes Study Group

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Patterson, C.C., Carson, D.J., Hadden, D.R. et al. Epidemiology of childhood IDDM in Northern Ireland 1989–1994: Low incidence in areas with highest population density and most household crowding. Diabetologia 39, 1063–1069 (1996). https://doi.org/10.1007/BF00400655

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  • DOI: https://doi.org/10.1007/BF00400655

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