Spring harvest? Reflections on the rise of type 1 diabetes

Childhood diabetes appears to have been a relatively rare disorder in Europe and North America in the first half of the 20th century, with incidence rates comparable to those seen in some Asian populations today. The incidence began to rise around the middle of the twentieth century, and an increase has been documented since then in many populations around the world [1]. For example, between 1989 and 1998, there was an overall year-on-year rise of 3.2% across Europe, equivalent to a doubling time of 25 years, and the most rapid relative increase was in children under the age of 5 years. Central and Eastern Europe, previously regions with a low incidence, now showed a rapid increase, suggesting a possible catch-up phenomenon [2]. A change of this magnitude in relatively stable populations cannot be explained by the increased transmission of diabetes susceptibility genes from one generation to the next, and strongly suggests some form of environmental influence.

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