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Is the incidence of type 1 diabetes in children and adolescents stabilising? The first 6 years of a National Register

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Abstract

The Irish Childhood Diabetes National Register (ICDNR) was established in 2008 to define accurately the incidence and monitor the epidemiology of type 1 diabetes (T1D) in the Irish population. Here, we report data from the first 6 years of the National Register and compare with previous national data. Prospective national incident data regarding T1D in those under 15 years resident in Ireland were collected from 2008 to 2013 and national incidence rates (IRs) calculated. Ascertainment completeness was assessed using capture-recapture methodology. The period identified 1566 new cases of T1D, ascertainment reached 96.8 % in 2013. The standardised incidence rate was 27.5 in 2008 stabilising at 28.7 and 28.8 cases /100,000/year in 2012 and 2013. There was no evidence that the incidence changed significantly in the 6-year period either overall or for each age group and gender. There was evidence of a difference in the incidence of T1D across the age groups with the overall incidence highest in the 10–14 year age category. A strong seasonal association was demonstrated.

Conclusions: This study confirms Ireland as a high-incidence country for type 1 diabetes whilst demonstrating that the previous marked increase in IR from 16.3 cases/100,000/year in 1997 has not continued. Ongoing monitoring through the robust mechanism of the ICDNR is required to clarify whether this is a fluctuation or if the incidence of T1D diabetes has stopped rising in our population. Alternatively, this apparent stabilisation may reflect a shift to a later age at diagnosis.

“What is known :”

• The incidence of Type 1 diabetes (T1D) is increasing in most populations worldwide although in certain high-incidence populations, it may be stabilising

• There was a marked increase in T1D in Ireland between 1997 and 2008

• T1D incidence increases with affluence

“What is New:”

• The high incidence of T1D in Ireland has been confirmed at 28.8 cases/100,000/year in 2013 and has been effectively stable in the period 2008–2013

• Incidence is highest in Irish 10–14 year olds

• Changes in incidence possibly reflecting life style and economic climate

• Marked seasonality of diagnosis confirmed

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Abbreviations

GDP:

Gross domestic product

ICDNR:

The Irish Childhood Diabetes National Register

IRs:

Incidence rates

PCRS:

Primary Care Reimbursement Service

ROI:

Republic of Ireland/Ireland

SJH/AMNCH:

St. James Hospital and the Adelaide and Meath Hospital incorporating the National Children’s Hospital

T1D:

Type 1 diabetes

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Acknowledgments

We are grateful to the Primary Care Reimbursement Services (PCRS) for their assistance, Mr. B. Carr ICT Tallaght Hospital and Professor J Grimson, University of Dublin, Trinity College Dublin and HIQA, for their advice and support in the development of the ICDNR.

We are particularly grateful to all the participating centres, paediatric endocrinologists, paediatricians, parents and children with type 1 diabetes.

Authors’ contributions

E.R. conceived the project, wrote the manuscript and researched data. A.McK. researched data and reviewed/edited the manuscript. K.R. reviewed/edited the manuscript. A.B. reviewed/edited the manuscript. M.O’R. researched data and reviewed/edited the manuscript. H.H. contributed to the discussion and reviewed/edited the manuscript. E.R. is the guarantor for this paper.

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Authors and Affiliations

  1. The Department of Paediatric Growth, Diabetes and Endocrinology, National Children’s Hospital, Trinity Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland

    Edna F. Roche, Adrienne A. Brennan & Hilary MCV Hoey

  2. The Discipline of Paediatrics and Child Health, The University of Dublin, Trinity College Dublin, Dublin, Ireland

    Edna F. Roche, Amanda M. McKenna & Hilary MCV Hoey

  3. Information Communication Technology Department, Tallaght Hospital, Dublin, Ireland

    Kerry J Ryder

  4. Department of Statistics, The University of Dublin, Trinity College Dublin, Dublin, Ireland

    Myra O’Regan

Authors
  1. Edna F. Roche
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  2. Amanda M. McKenna
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  3. Kerry J Ryder
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  4. Adrienne A. Brennan
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  5. Myra O’Regan
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  6. Hilary MCV Hoey
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Corresponding author

Correspondence to Edna F. Roche.

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Funding

This study and the Irish Childhood Diabetes National Register was funded a grant from the National Children’s Hospital Foundation Ireland since its inception.

Conflict of interest

The authors declare that they have no competing interests. The authors do not have a financial relationship with the National Children’s Hospital Foundation who sponsored this study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments. Ethical approval for the ICDNR was granted by the SJH/AMNCH Joint Research Ethics Committee in accordance with the Declaration of Helsinki.

Informed consent

Written informed consent was obtained from all individual participants included in the National Diabetes Register.

Additional information

Communicated by Beat Steinmann

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Roche, E.F., McKenna, A.M., Ryder, K.J. et al. Is the incidence of type 1 diabetes in children and adolescents stabilising? The first 6 years of a National Register. Eur J Pediatr 175, 1913–1919 (2016). https://doi.org/10.1007/s00431-016-2787-6

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  • DOI: https://doi.org/10.1007/s00431-016-2787-6

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