Abstract
The objective was to test whether the pattern of increase in incidence of type I diabetes in children under 20 y of age varies with age at onset in France during 1988–1997. The French register of insulin-dependent diabetes was based on the direct identification of new cases by a prospective registration in children under the age of 20 y. Data from the French Social Security were used as a secondary independent source of cases. The rate of ascertainment was ≥95% over the 10-y period studied. Data were analyzed using linear regression; departure from a linear trend was tested in each age group. A total of 1867 children under 20 y of age at the time of diagnosis were included. The incidence rate of type I diabetes in children rose significantly between 1988 and 1997, from 7.41 per 100,000 per year (95% confidence interval: 6.55–8.27) to 9.58 per 100,000 per year (95% confidence interval: 8.64–10.52) with p = 0.0001. The percentage increase was greates in the 0–4 y age group, with a significant departure from linear trend (p = 0.036), reflecting an acceleration of the increase. Incidence rates rose linearly in 5–9 y (average increase 0.43 per 100,000 per year, p = 0.011) and 10–14 y (average increase 0.40 per 100,000 per year, p = 0.002) age groups, whereas it remained stable in the 15–19 y age group (p = 0.77). The incidence rate was significantly higher in boys than in girls (p = 0.005), but the rise in incidence did not differ between the two genders. The rise in incidence of type I diabetes in France was of the same magnitude as observed in the rest of Europe over 10 y. A specific pattern was observed in children under 5 y of age, contrasting with stable rates over 15 y. These data suggest a shift toward a younger age at onset of type I diabetes in childhood, contributing, at least in part, to the observed increase in incidence of type I diabetes in children.
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Acknowledgements
The authors thank the physicians at the Medical Department of Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés (CNAMTS) for their valuable contribution to the register. We also thank all the physicians involved in the register network for their fruitful participation.
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This work was supported by a joint grant from the Direction de la Santé et Institut National de la Santé et de la Recherche Médicale (Paris, France) from 1990 to 1994. This study was part of the EURODIAB network, supported by grants from the European Union (European Community Concerted Action Program: Grants BMH1-CT92-0043 and BMH4-CT96-0577).
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Charkaluk, ML., Czernichow, P. & Lévy-Marchal, C. Incidence Data of Childhood-Onset Type I Diabetes in France During 1988–1997: The Case for a Shift Toward Younger Age at Onset. Pediatr Res 52, 859–862 (2002). https://doi.org/10.1203/00006450-200212000-00008
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DOI: https://doi.org/10.1203/00006450-200212000-00008
