The incidence of type 1 diabetes among children in Finland--rural-urban difference.

The aim of the study was to investigate the incidence of type 1 diabetes among children aged 14 years or under according to the level of urbanization of the place of residence of children at the time of diagnosis in Finland during 1987 to 1996. The analysis was carried out using a Bayesian approach and GIS. The incidence was the highest in the rural heartland areas while the increase in incidence was sharpest in urban areas. The level of urbanization seems to explain only a part of the spatial variation in the incidence in Finland. It is possible that some environmental risk factors for type 1 diabetes have been more prevalent in rural heartland areas than in the rest of the country. These factors might have increased in urban environments in Finland particularly during the first half of 1990s.

[1]  J. Tuomilehto,et al.  Large incidence variation of Type I diabetes in central-southern Italy 1990–1995: lower risk in rural areas , 1999, Diabetologia.

[2]  A. Green,et al.  The large increase in incidence of Type I diabetes mellitus in Poland , 2001, Diabetologia.

[3]  P. Levallois,et al.  [Contamination of drinking water by nitrates: analysis of health risks]. , 1994, Canadian journal of public health.

[4]  M. Delmée,et al.  OMEPRAZOLE, CAMPYLOBACTER PYLORI, AND DUODENAL ULCER , 1989, The Lancet.

[5]  F. Chiarelli,et al.  Regional Variability in the Epidemiology of Childhood Diabetes in Italy , 1997, Journal of pediatric endocrinology & metabolism : JPEM.

[6]  L. Bernardinelli,et al.  Bayesian methods for mapping disease risk , 1996 .

[7]  S. Virtanen,et al.  Nitrate and Nitrite Intake and the Risk for Type 1 Diabetes in Finnish Children , 1994 .

[8]  T. Chowdhury,et al.  The aetiology of Type 1 diabetes , 1999 .

[9]  P. Smith,et al.  Geographical Variation in the Incidence of Diabetes Mellitus in Scottish Children During the Period 1977–1983 , 1988, Diabetic medicine : a journal of the British Diabetic Association.

[10]  D. Clayton,et al.  The Sardinian IDDM Study: 1. Epidemiology and geographical distribution of IDDM in Sardinia during 1989 to 1994 , 1998, Diabetologia.

[11]  L Bernardinelli,et al.  Empirical Bayes versus fully Bayesian analysis of geographical variation in disease risk. , 1992, Statistics in medicine.

[12]  P. Swift,et al.  Diabetes in Asian children , 1990, The Lancet.

[13]  A. Staines,et al.  Evidence for an environmental effect in the aetiology of insulin dependent diabetes in a transmigratory population. , 1992, BMJ.

[14]  Frederick R. Broome,et al.  Geographic information systems (GIS): new perspectives in understanding human health and environmental relationships. , 1996, Statistics in medicine.

[15]  C. Patterson,et al.  Epidemiology of childhood IDDM in Northern Ireland 1989–1994: Low incidence in areas with highest population density and most household crowding , 1996, Diabetologia.

[16]  J. Ilonen,et al.  Epidemiology of childhood diabetes mellitus in Finland — background of a nationwide study of Type 1 (insulin-dependent) diabetes mellitus , 2004, Diabetologia.

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

[18]  M. Rewers,et al.  Trends in the prevalence and incidence of diabetes: insulin-dependent diabetes mellitus in childhood. , 1988, World health statistics quarterly. Rapport trimestriel de statistiques sanitaires mondiales.

[19]  G. Dahlquist.  The aetiology of type 1 diabetes: an epidemiological perspective , 1998, Acta paediatrica (Oslo, Norway : 1992). Supplement.

[20]  Jack Cuzick,et al.  Geographical and environmental epidemiology : methods for small-area studies , 1997 .

[21]  S. Virtanen,et al.  Feeding in Infancy and the Risk of Type 1 Diabetes Mellitus in Finnish Children , 1992, Diabetic medicine : a journal of the British Diabetic Association.

[22]  A. Green,et al.  Trends in the incidence of childhood-onset diabetes in Europe 1989–1998 , 2001, Diabetologia.

[23]  G. Giani,et al.  Temporal, seasonal, and geographical incidence patterns of Type I diabetes mellitus in children under 5 years of age in Germany , 1999, Diabetologia.

[24]  G. Bruno,et al.  Effect of Sardinian heritage on risk and age at onset of type 1 diabetes: a demographic case-control study of Sardinian migrants. , 2000, International journal of epidemiology.

[25]  G. Dahlquist,et al.  Childhood onset diabetes--time trends and climatological factors. , 1994, International journal of epidemiology.

[26]  L. Räsänen,et al.  Nitrate, nitrite, and N-nitroso compounds in Finnish foods and the estimation of the dietary intakes , 1990, Zeitschrift fur Lebensmittel-Untersuchung und -Forschung.

[27]  Patterson Cc.  Incidence of childhood-onset insulin-dependent diabetes mellitus. , 1992 .

[28]  J. Tuomilehto,et al.  The onset age of type 1 diabetes in Finnish children has become younger. The Finnish Childhood Diabetes Registry Group. , 1999, Diabetes care.

[29]  J. Tuomilehto,et al.  Bayesian analysis of geographical variation in the incidence of Type I diabetes in Finland , 2001, Diabetologia.

[30]  M. MacDonald.  Hypothesis: The Frequencies of Juvenile Diabetes in American Blacks and Caucasians Are Consistent with Dominant Inheritance , 1980, Diabetes.

[31]  J. Tuomilehto,et al.  HLA antigens in insulin-dependent diabetes mellitus. , 1991, Annals of medicine.

[32]  G. Gallus,et al.  Insulin-dependent diabetes mellitus in Sardinian-heritage children living in Lombardy , 1998, The Lancet.

[33]  P. Bingley,et al.  Rising incidence of insulin dependent diabetes in children aged under 5 years in the Oxford region: time trend analysis , 1997, BMJ.

[34]  N. Waugh,et al.  Urban/rural and deprivational differences in incidence and clustering of childhood diabetes in Scotland. , 1992, International journal of epidemiology.

[35]  D. Clayton,et al.  Empirical Bayes estimates of age-standardized relative risks for use in disease mapping. , 1987, Biometrics.

[36]  F. Alexander,et al.  Small area variation in the incidence of childhood insulin-dependent diabetes mellitus in Yorkshire, UK: links with overcrowding and population density. , 1997, International journal of epidemiology.

[37]  J. Tuomilehto,et al.  Regional differences in the incidence of insulin-dependent diabetes mellitus among children in Finland from 1987 to 1991. Childhood Diabetes in Finland (DiMe) Study Group. , 1997, Annals of medicine.

[38]  J. Besag,et al.  Bayesian image restoration, with two applications in spatial statistics , 1991 .

[39]  M. Metcalfe,et al.  Incidence of insulin dependent diabetes in children aged under 15 years in the British Isles during 1988. , 1991, BMJ.

[40]  J. Roseman,et al.  Evidence for Genetic Admixture as a Determinant in the Occurrence of Insulin-dependent Diabetes Mellitus in U.S. Blacks , 1982, Diabetes.

[41]  J. Tuomilehto,et al.  Record-high incidence of Type I (insulin-dependent) diabetes mellitus in Finnish children , 1999, Diabetologia.

[42]  O. Søvik,et al.  Increasing incidence of diabetes mellitus in Norwegian children 0–14 years of age 1973–1982 , 1989, Diabetologia.

[43]  J. Tuomilehto,et al.  Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. , 2000, Diabetes care.

[44]  D. Pyke,et al.  The significance of the concordance rate for Type 1 (insulin-dependent) diabetes in identical twins , 1988, Diabetologia.

[45]  T. Tarvainen,et al.  Application of a groundwater contamination index in Finland and Slovakia , 1998 .

[46]  J. Tuomilehto,et al.  Increase in incidence of insulin-dependent diabetes mellitus among children in Finland. , 1995, International journal of epidemiology.

[47]  H. Festenstein,et al.  A NEW LOOK AT HLA GENETICS WITH PARTICULAR REFERENCE TO TYPE-1 DIABETES , 1979, The Lancet.

[48]  David J. Maguire,et al.  Geographical information systems : principles and applications , 1991 .

[49]  J. Tuomilehto,et al.  Incidence trends in childhood onset IDDM in four countries around the Baltic sea during 1983–1992 , 1997, Diabetologia.

[50]  R. Chakraborty,et al.  Caucasian genes in American blacks: new data. , 1992, American journal of human genetics.

[51]  E. Lesaffre,et al.  Disease mapping and risk assessment for public health. , 1999 .

[52]  M. J. Donald.  Lower frequency of diabetes among hospitalized Negro than white children: theoretical implications. , 1975 .

[53]  L. Irwig,et al.  Environmental Factors in Childhood IDDM: A population-based, case-control study , 1994, Diabetes Care.

[54]  S. Muntoni,et al.  Incidence of insulin-dependent diabetes mellitus among Sardinianheritage children born in Lazio region, Italy , 1997, The Lancet.

[55]  A. Staines,et al.  Geographical Mapping of Childhood Diabetes in the Northern English County of Yorkshire , 1996, Diabetic medicine : a journal of the British Diabetic Association.

[56]  K. Alberti,et al.  PREVALENCE OF DIABETES AND IMPAIRED GLUCOSE TOLERANCE IN RURAL TANZANIA , 1989, The Lancet.

[57]  T. M. Szopa,et al.  Diabetes mellitus due to viruses — some recent developments , 1993, Diabetologia.

[58]  Paige L. Tompkins,et al.  Geographic information systems (GIS): implications for promoting social and economic justice , 1999 .

[59]  M. Rewers,et al.  Increasing trend in Type 1 (insulin-dependent) diabetes mellitus in childhood in Finland , 1991, Diabetologia.

[60]  C Montomoli,et al.  Spatial correlation in ecological analysis. , 1993, International journal of epidemiology.

[61]  G. Dahlquist,et al.  Dietary factors and the risk of developing insulin dependent diabetes in childhood. , 1990, BMJ.

[62]  J. Stengård,et al.  Concordance for Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes mellitus in a population-based cohort of twins in Finland , 1992, Diabetologia.

[63]  J. Tuomilehto.  Geographic Patterns of Childhood Insulin-Dependent Diabetes Mellitus , 1988, Diabetes.

[64]  A. Green,et al.  Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURODIAB ACE study , 1992, The Lancet.