TY - JOUR
T1 - Decreased incidence of type 1 diabetes in young Finnish children
AU - Parviainen, Anna
AU - But, Anna
AU - Siljander, Heli
AU - Knip, Mikael
AU - Finnish Pediatric Diabetes Register
N1 - Funding Information:
Acknowledgments. The authors thank all of the participants, hospitals, and personnel of the Finnish Pediatric Diabetes Register. Funding. The study was supported by the Academy of Finland (decision number 292538), the Sigrid Jusélius Foundation, Finska Läkaresällskapet, and the Liv and Hälsa Fund. Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. A.P. analyzed the data and wrote and edited the manuscript. A.B. performed part of the statistical analyses and reviewed and edited the manuscript. H.S. reviewed and edited the manuscript. M.K. planned the study, contributed to the discussion, and reviewed and edited the manuscript. All authors approved the final manuscript. M.K. is the guarantor of this work and, as such, had full access to all the data in the studyandtakesresponsibilityfortheintegrityofthe data and the accuracy of the data analysis.
Publisher Copyright:
© 2020 by the American Diabetes Association.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - OBJECTIVE The incidence of type 1 diabetes has been rising for decades, particularly among young children. Between 2006 and 2011, the incidence rate (IR) reached a plateau in Finland. In this observational, register-based cohort study, we assess recent trends in the disease rate in Finnish children. RESEARCH DESIGN AND METHODS Based ondata fromthe Finnish Pediatric Diabetes Register, we studiedthe incidence of type 1 diabetes among children younger than 15 years of age between 2003 and 2018. We assessed sex-specific IRs per 100,000 person-years (PY) by 4-year time periods in three age-groups (0.50–4.99, 5.00–9.99, and 10.00–14.99 years). RESULTS Among the 7,871 children with newly diagnosed type 1 diabetes, the median age at diagnosis increased from 7.88 to 8.33 years (P 5 0.001), while the overall IR decreased from 57.9/100,000 PY in 2003–2006 to 52.2/100,000 PY in 2015–2018, yielding an IR ratio (IRR) of 0.90 (95% CI 0.85–0.96, P 5 0.001). This decline was mainly due to the decrease in the youngest age-group (IRR 0.77 [95% CI 0.68–0.87]; P < 0.001), being significant both among boys and girls. In the middle age-group, a significant decrease was observed only among girls. No changes were observed in the oldest children. CONCLUSIONS The incidence of type 1 diabetes decreased among young Finnish children between 2003 and 2018. Current findings imply that environmental factors driving the immune system toward islet autoimmunity are changing in young children.
AB - OBJECTIVE The incidence of type 1 diabetes has been rising for decades, particularly among young children. Between 2006 and 2011, the incidence rate (IR) reached a plateau in Finland. In this observational, register-based cohort study, we assess recent trends in the disease rate in Finnish children. RESEARCH DESIGN AND METHODS Based ondata fromthe Finnish Pediatric Diabetes Register, we studiedthe incidence of type 1 diabetes among children younger than 15 years of age between 2003 and 2018. We assessed sex-specific IRs per 100,000 person-years (PY) by 4-year time periods in three age-groups (0.50–4.99, 5.00–9.99, and 10.00–14.99 years). RESULTS Among the 7,871 children with newly diagnosed type 1 diabetes, the median age at diagnosis increased from 7.88 to 8.33 years (P 5 0.001), while the overall IR decreased from 57.9/100,000 PY in 2003–2006 to 52.2/100,000 PY in 2015–2018, yielding an IR ratio (IRR) of 0.90 (95% CI 0.85–0.96, P 5 0.001). This decline was mainly due to the decrease in the youngest age-group (IRR 0.77 [95% CI 0.68–0.87]; P < 0.001), being significant both among boys and girls. In the middle age-group, a significant decrease was observed only among girls. No changes were observed in the oldest children. CONCLUSIONS The incidence of type 1 diabetes decreased among young Finnish children between 2003 and 2018. Current findings imply that environmental factors driving the immune system toward islet autoimmunity are changing in young children.
U2 - 10.2337/dc20-0604
DO - 10.2337/dc20-0604
M3 - Article
C2 - 32998988
AN - SCOPUS:85096494903
SN - 0149-5992
VL - 43
SP - 2953
EP - 2958
JO - DIABETES CARE
JF - DIABETES CARE
IS - 12
ER -
