Incidence of Childhood Type 1 and Non-Type 1 Diabetes Mellitus in a Diverse Population: The Chicago Childhood Diabetes Registry, 1994 to 2003

BACKGROUND Reports of increasing risk for type 1 (T1) and type 2 diabetes mellitus in youth are emerging, but information on socioeconomically diverse populations is limited. METHOD The Chicago Childhood Diabetes Registry is a city-wide study of patients 0-17 years old at onset. Incidence data came from medical records and interviews; census data provided denominators; analyses used Poisson regression. Non-type 1 (nT1) patients had a type 2-like clinical course or related indicators. RESULTS There were 1,366 incident cases: 719 in non-Hispanic Black (NHB), 379 in Hispanic, 229 in non-Hispanic White (NHW), and 39 in children of other ethnicities. Average annual incidence was 16.0 (95% CI: 14.6, 17.6)/10(5) for boys, 20.1 (18.3, 22.1)/10(5) for girls, and 18.1 (16.9, 19.3)/10(5) overall. Risk was 21.6 (19.6, 23.8)/10(5) for NHB, 14.6 (13.0, 16.4)/10(5) for Hispanic, and 18.1 (15.9, 20.6)/10(5) for NHW. Children aged 10-14 years experienced the highest incidence, irrespective of ethnicity. T1 was predominant in all ethnic groups, except NHB, where the rates of T1 and nT1 were similar. Over ten years there was a marked increase in all childhood diabetes in Chicago, averaging 2.73% (95% CI: 0.49, 5.02) per annum, adjusted for age. This increase was confined to nT1, with an average annual percent change of +6.23% (2.28, 10.34), while T1 incidence remained stable. CONCLUSIONS Incidence of childhood diabetes increased between 1994-2003, driven primarily by nT1, suggesting a role for behavioral and/or environmental determinants of insulin resistance. These estimates are likely to be conservative, if nT1 cases were more apt to be missed.

[1]  Michael M. Engelgau,et al.  Type 2 diabetes among North adolescents: An epidemiologic health perspective , 2000 .

[2]  Goutham Rao,et al.  Childhood Obesity and Type 2 Diabetes Mellitus , 2005, Pediatrics.

[3]  S. Freels,et al.  Incidence and onset features of diabetes in African‐American and Latino children in Chicago, 1985–1994 , 2002, Diabetes/metabolism research and reviews.

[4]  W. Deming,et al.  On a Method of Estimating Birth and Death Rates and the Extent of Registration (Excerpt) , 1949 .

[5]  S. Daniels,et al.  Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. , 1996, The Journal of pediatrics.

[6]  E. Hathout,et al.  Air pollution and type 1 diabetes in children , 2006, Pediatric diabetes.

[7]  C. J. Macaluso,et al.  Type 2 Diabetes Mellitus among Florida Children and Adolescents, 1994 through 1998 , 2002, Public health reports.

[8]  P. McCullagh,et al.  Generalized Linear Models , 1984 .

[9]  M G Kenward,et al.  Obesity, increased linear growth, and risk of type 1 diabetes in children. , 2000, Diabetes care.

[10]  Beth A Virnig,et al.  Using a Spanish surname match to improve identification of Hispanic women in Medicare administrative data. , 2006, Health services research.

[11]  P. Crock,et al.  The rising incidence of childhood type 1 diabetes in New South Wales, 1990–2002 , 2005, The Medical journal of Australia.

[12]  C. Beaufort.  Incidence and trends of Childhood Type 1 diabetes worldwide 1990-1999 , 2006 .

[13]  J. Dorman,et al.  Increasing incidence of type 1 diabetes in population from Santiago of Chile: trends in a period of 18 years (1986–2003) , 2006, Diabetes/metabolism research and reviews.

[14]  R. LaPorte,et al.  Evidence for heterogeneous pathogenesis of insulin-treated diabetes in black and white children. , 2003, Diabetes care.

[15]  K. Jones,et al.  Non-Insulin Dependent Diabetes in Children and Adolescents: The Therapeutic Challenge , 1998, Clinical pediatrics.

[16]  J. Ludvigsson,et al.  A high weight gain early in life is associated with an increased risk of Type 1 (insulin-dependent) diabetes mellitus , 2004, Diabetologia.

[17]  T. Wilkin.  The accelerator hypothesis: weight gain as the missing link between Type I and Type II diabetes , 2001, Diabetologia.

[18]  G. Duncan.  Prevalence of diabetes and impaired fasting glucose levels among US adolescents: National Health and Nutrition Examination Survey, 1999-2002. , 2006, Archives of pediatrics & adolescent medicine.

[19]  Word Dl,et al.  Building a Spanish surname list for the 1990s--a new approach to an old problem. , 1996 .

[20]  J. Tuomilehto,et al.  Worldwide increase in incidence of Type I diabetes – the analysis of the data on published incidence trends , 1999, Diabetologia.

[21]  L S Geiss,et al.  Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. , 2000, The Journal of pediatrics.

[22]  P. Simpson,et al.  Statistical methods in cancer research , 2001, Journal of surgical oncology.

[23]  U. Das.  Is obesity an inflammatory condition? , 2001, Nutrition.

[24]  M. Cradock,et al.  Characteristics of youth-onset noninsulin-dependent diabetes mellitus and insulin-dependent diabetes mellitus at diagnosis. , 1997, Pediatrics.

[25]  J. Viel,et al.  Increasing trend of childhood Type 1 diabetes in Franche-Comté (France): Analysis of age and period effects from 1980 to 1998 , 2005, European Journal of Epidemiology.