Incidence of type 1 diabetes in children nearly doubled in some populations
SAN FRANCISCO — In an ongoing analysis of the pediatric population in Philadelphia, a presenter here showed that the rate of both type 1 diabetes is increasing, with some populations and age groups increasing greatly since the first cohort from 1985 to 1989.
In the Philadelphia Pediatric Diabetes Registry, the incidence of type 1 diabetes from 2005 to 2009 was 17% higher than in previous cohorts, 49% higher over the span of the registry and had increased in each racial/ethnic and age group. The most marked increase was in children under the age of 5 years; which was 26% higher than the previous cohort and doubled over the span of the registry.
Terri Lipman, PhD, CRNP, FAAN, and colleagues analyzed in-patient and out-patient charts from subjects at Philadelphia hospitals who met WHO registry criteria: those with newly diagnosed diabetes, aged 0 to 14 years, residing in Philadelphia at the time of diagnosis and diagnosed between Jan. 1, 2005, to Dec. 31, 2009.
“Research on the risk factors associated with the significant rise, particularly in young children, must continue. And, most importantly, [increasing awareness among] primary care providers and parents of the rising incidence of type 1 diabetes in young children is crucial,” Lipman, professor of nursing at the University of Pennsylvania School of Nursing and clinician at the Children’s Hospital of Philadelphia, said during her presentation at the American Diabetes Association’s 74th Scientific Sessions.
Changes found between cohorts
Researchers found a total of 290 cases of type 1 diabetes, averaging the highest incidence rate — 19.9 per 100,000 people per year — since the Philadelphia Pediatric Diabetes Registry began in 1985. Since that initial cohort studied from 1985 to 1989, incidence of type 1 diabetes in Philadelphia has increased by 48.5% (P<.001), Lipman showed.
The increase in type 1 diabetes was demonstrated in all racial/ ethnic groups, (22.5/100,000/year for whites, 14.6/100,000/year for blacks and 16.6/100,000/year for Hispanics). The greatest overall racial/ethnic increase was shown in white children with a rate of type 1 diabetes that has increased by 69% since 1985 (P<.001). There was a 33% increase in the rates for blacks and a 10% increase in the rate for Hispanics over the 25 years of study, Lipman said.
“The incidence of type 1 diabetes has increased in all age groups. Most notably, the incidence of type 1 diabetes has more than doubled in the 0- to 4-year age group over the past 20 years (P<.001) and the incidence continues to rise,” she said.
The increase in the 5- to 9-year age group was 55%, while the 10- to14-year age group rate increased by 26%. In this time-period cohort, “for the first time in the history of the registry,” the highest incidence was in the 5- to 9-year age group at 23.4 per 100,000 people per year.
The most marked increase in the 0- to 4-year age group was seen in black children at 220% in the past 25 years, Lipman said. She explained the risk of developing type 1 diabetes in black children under age 5 years from 2005 to 2009 was 3.2 times the risk compared to the original cohort. In comparison, there was a 28% increase in whites and 88% increase in Hispanic populations.
Prevalence of type 2 diabetes
Additionally, researchers identified 65 cases of type 2 diabetes for an overall incidence of 4.4 per 100,000 people per year, which is lower than in the last cohort. Black children were significantly more affected by type 2 diabetes (48 cases vs. two white cases and nine Hispanic cases) and 92% of the cases (n=60) identified were in the 10- to 14-year age group.
“We cannot confirm this as an actual decrease until we’ve completed data collection from the secondary source, where a number of additional cases may be identified,” Lipman said.
Disclosures: Lipman reports no relevant financial relationships.
For More Information: Lipman T. Abstract 167-OR. Presented at: American Diabetes Association’s 74th Scientific Sessions; June 13-17, 2014; San Francisco.