Acta Diabetologica

, Volume 51, Issue 6, pp 947–953 | Cite as

Rapidly rising incidence of childhood type 1 diabetes in Chinese population: epidemiology in Shanghai during 1997–2011

  • Zhuhui Zhao
  • Chengjun Sun
  • Chunfang Wang
  • Pin Li
  • Wei Wang
  • Jun Ye
  • Xuefan Gu
  • Xiaodong Wang
  • Shuixian Shen
  • Dijing Zhi
  • Zhong Lu
  • Rong Ye
  • Ruoqian Cheng
  • Li Xi
  • Xiaojing Li
  • Zhangqian Zheng
  • Miaoying Zhang
  • Feihong LuoEmail author
Original Article


The aim of this study was to investigate incidence trend of childhood type 1 diabetes in Shanghai, a megalopolis in east China. We established a population-based retrospective registry for the disease in the city’s registered population during 1997–2011 and collected 622 incident type 1 diabetes in children aged 0–14 years. Standardized incidence rates and 95 % CI were estimated by applying the capture–recapture method and assuming Poisson distribution. Incidence trend was analyzed using the Poisson regression model. The mean annual incidence of childhood type 1 diabetes was 3.1 per 100,000 person-years. We did not observe significant difference in incidence between boys and girls. The incidence is unstable and had a mean annual increase 14.2 % per year during the studied period. A faster annual increase was observed in boys, warmer seasons, and in the outer regions of the city. If present trends continue, the number of new type 1 diabetes cases will double from 2016 to 2020, and prevalent cases will sextuple by 2025. Our results showed the incidence of childhood type 1 diabetes was rising rapidly in Shanghai. More studies are needed to analyze incidence changes in other regions of China for appropriate allocation of healthcare resources.


Chinese Childhood Type 1 diabetes Epidemiology Incidence Increase 



We thank the Shanghai Municipal Center for Disease Control and Prevention, and Shanghai Municipal Human Resources and Social Security Bureau for their generous support for this study. We are grateful to Dr. Xiaoling Ge from the department of informatics at Children’s Hospital of Fudan University for her valuable support in the administration of data archive. We are also grateful to Dr. Francine R. Kaufman for her suggestions in English language. CS thanks support from EFSD in the form of EFSD/CDS/Lilly fellowship and support from Chinese Scholarship Council (2009610015). The study is supported by the Chinese National Twelfth Five Year Key Science and Technology Plan (2012BAI09B00).

Conflict of interest

The authors declared no conflict of interest.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

The data collection, distribution, and publication procedures of our study have been reviewed and approved by the Faculty Hospital Ethics Committee in Children’s Hospital of Fudan University, and the need for individual informed consent was waived by the committee.


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Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Zhuhui Zhao
    • 1
  • Chengjun Sun
    • 1
    • 2
  • Chunfang Wang
    • 3
  • Pin Li
    • 4
  • Wei Wang
    • 5
  • Jun Ye
    • 6
  • Xuefan Gu
    • 6
  • Xiaodong Wang
    • 7
  • Shuixian Shen
    • 1
  • Dijing Zhi
    • 1
  • Zhong Lu
    • 1
  • Rong Ye
    • 1
  • Ruoqian Cheng
    • 1
  • Li Xi
    • 1
  • Xiaojing Li
    • 1
  • Zhangqian Zheng
    • 1
  • Miaoying Zhang
    • 1
  • Feihong Luo
    • 1
    Email author
  1. 1.Department of Pediatric Endocrinology and Inherited Metabolic DiseaseChildren’s Hospital of Fudan UniversityShanghaiChina
  2. 2.Department of Medicine (Solna), Center for Molecular MedicineKarolinska InstitutetStockholmSweden
  3. 3.Vital Statistics DepartmentShanghai Municipal Center for Disease Control and PreventionShanghaiChina
  4. 4.Department of Pediatric Endocrinology, Shanghai Children’s HospitalJiaotong UniversityShanghaiChina
  5. 5.Department of Pediatric Endocrinology, Ruijin HospitalJiaotong UniversityShanghaiChina
  6. 6.Shanghai Pediatric Institute, Xinhua HospitalJiaotong UniversityShanghaiChina
  7. 7.Department of Pediatric Endocrinology, Shanghai Children’s Medical CenterJiaotong UniversityShanghaiChina

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