Diabetes mellitus type 1 epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]Anahita Deylamsalehi, M.D.[3]
Overview
Epidemiology and demographics of type 1 diabetes mellitus varies with geography, age, race and genetic susceptibility. Incidence of type 1 diabetes mellitus has been increased within the last decade and there are nearly 15-30 million of affected patients around the world. Most type 1 diabetes mellitus patients are children and since it's incidence dwindles after puberty, only one fourth of patients are diagnosed in their adulthood. The incidence of type 1 diabetes mellitus is related to race and ethnicity of patients. For instance, studies demonstrated that Non-Hispanic white patients have a higher type 1 diabetes mellitus incidence, compared to other races, whereas American Indians had the lowest type 1 diabetes mellitus incidence. Finland has the highest incidence of type 1 diabetes mellitus in the world.
Epidemiology and Demographics
Incidence
- Incidence of type 1 diabetes mellitus varies with geography, age, race, and genetic susceptibility.
- Epidemiology and demographics of type 1 diabetes mellitus among children:[1][2][3][4][5][6][7][8][9][10]
- At a rate of 3-5% each year since 1960, the incidence of type 1 diabetes mellitus is increasing among children for not fully understood etiologies.[11] Although it can be interpreted that environmental factors could be at least partially responsible, since genetic factors can not intervene in such a short time.[12]
- In one study, incidence of type 1 diabetes mellitus in youth of the United States reported 24.3 (95% confidence interval CI, 23.3-25.3).[13]
- Another study done in Belgium reported an average of 9.9 new cases of diabetes mellitus type 1 per 100,000 individuals per year.[14]
| Factors affecting the incidence of type 1 diabetes mellitus | Relationship between factors and incidence of type 1 diabetes mellitus | Epidemiology |
|---|---|---|
| Geography | Incidence elevates with increased distance from equator | Incidence of type 1 diabetes mellitus per 100,000 persons a year
0.1 to 0.5 per 100,000 persons in Venezula and parts of China 37 to 65 in Finland and Sardinia 23.6 per 100,000 per year in non-Hispanic white children and adolescents 36 per 100,000 per year in Newfoundland, Canada |
| Gender | Gender doesn't affect the overall incidence of childhood type 1 diabetes mellitus | The prevalence and incidence of type 1 diabetes mellitus doesn't vary with gender. |
| Genetic susceptibility | There is an increased risk of developing type 1 diabetes mellitus in close relatives of a patient with type 1 diabetes mellitus | Lifetime risk of developing Type 1 DM
●No family history – 0.4 percent ●Offspring of an affected mother – 1 to 4 percent ●Offspring of an affected father – 3 to 8 percent ●Offspring with both parents affected – reported as high as 30 percent ●Non-twin sibling of affected patient – 3 to 6 percent ●Dizygotic twin – 8 percent ●Monozygotic twin – 30 percent within 10 years of diagnosis of the first twin, and 65 percent concordance by age 60 years |
| Race | Incidence of type 1 diabetes mellitus varies from race to race | Non-Hispanic white youth-2.55 ases per 1,000 children 0 to 19 years old
African American- 1.62 cases per 1,000 children 0 to 19 years old Hispanic-1.29 cases per 1,000 children 0 to 19 years old Asian-Pacific Islanders-0.6 cases per 1,000 children 0 to 19 years old American Indians-0.35 cases per 1,000 children 0 to 19 years old, respectively) |
Prevalence
- Type 1 diabetes affects ~15-30 million people globally.[1]
- In 2012, Ada estimated the prevalence of type 1 diabetes mellitus in american children and adults at 1.25 million.[2]
- 5.6% of american adults diagnosed with diabetes mellitus have type 1 diabetes mellitus.[15]
Case-fatality rate/Mortality rate
- The mortality rate among type 1 diabetes mellitus patients was 2.2/1000, based on a study done on Norwegian patients who were diagnosed between 1973 and 1982.[16]
Age
- Bimodal distribution, with one peak at four to six years of age and a second between 10 to 14 years of age.
- More than 85% of patients with type 1 diabetes mellitus are younger than 20 years old.[17]
- A study done on European population demonstrated that recent incidence of type 1 diabetes mellitus was highest among individuals younger than 4 years old.[18] Nevertheless, type 1 diabetes mellitus incidence wanes after puberty.[17]
- Even though the overall incidence of type 1 diabetes mellitus decreases after puberty, one fourth of individuals with type 1 diabetes mellitus are diagnosed as adults.[19]
Race
- In one study done on young population of the united states, type 1 diabetes mellitus were reported more frequent among non-Hispanic white, Hispanic and African Americans.[13]
- The following table is a summary of association between different races and diabetes mellitus type 1 incidence based on various age intervals:[17]
| Race/Ethnicity | 0–4 years | 5–9 years | 10–14 years | 15–19 years |
|---|---|---|---|---|
| Non-Hispanic white | 19.4 per 100,000 | 30.1 per 100,000 | 32.9 per 100,000 | 11.9 per 100,000 |
| African American | 12.0 per 100,000 | 19.3 per 100,000 | 21.3 per 100,000 | 9.5 per 100,000 |
| Hispanic | 10.2 per 100,000 | 18.2 per 100,000 | 18.4 per 100,000 | 8.7 per 100,000 |
| Asian and Pacific Islander | 5.2 per 100,000 | 7.6 per 100,000 | 9.1 per 100,000 | 5.7 per 100,000 |
| Navajo | 1.15 per 100,000 | 3.28 per 100,000 | 1.95 per 100,000 | 4.03 per 100,000 |
Gender
- Some studies suggest that males are more commonly affected by type 1 diabetes mellitus than females, although non-immunologic subtype of type 1 diabetes mellitus is more common in females.[20][[#cite_note-Blohm�Nystr�m1992-21|[21]]][22] On the other hand, another study suggests that both genders are equally affected.[23]
- A study of Caucasian population demonstrated male to female ratio of 1.7 among HLA-DR3 associated patients, whereas male to female ratio have been reported 1.0 among HLA-DR4 associated patients.[24]
Region
- Finland has the highest incidence of type 1 diabetes mellitus in the world.[25]
- The following is the list of regions which had an increased incidence of type 1 diabetes mellitus from 1990–1999:[17]
- Asia
- Europe
- North America
- The following is the list of regions which had a decreased incidence of type 1 diabetes mellitus from 1990-1999:[17]
- Central American
- The West Indies
- A study done on Gomel city population with radiation exposure after the Chernobyl incident demonstrated increased incidence of type 1 diabetes mellitus.[26]
References
- ↑ 1.0 1.1 "JDRF".
- ↑ 2.0 2.1 "ADA".
- ↑ http://www.diapedia.org/type-1-diabetes-mellitus/2104085168/epidemiology-of-type-1-diabetes
- ↑ https://www.idf.org/sites/default/files/attachments/DV_56-SI2.pdf
- ↑ Silink M. Childhood diabetes: a global perspective. Horm Res 2002; 57 Suppl 1:1.
- ↑ Harjutsalo V, Sund R, Knip M, Groop PH. Incidence of type 1 diabetes in Finland. JAMA 2013; 310:427.
- ↑ Bell RA, Mayer-Davis EJ, Beyer JW, et al. Diabetes in non-Hispanic white youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study. Diabetes Care 2009; 32 Suppl 2:S102.
- ↑ Dabelea D, Mayer-Davis EJ, Saydah S, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA 2014; 311:1778.
- ↑ Harjutsalo V, Sjöberg L, Tuomilehto J. Time trends in the incidence of type 1 diabetes in Finnish children: a cohort study. Lancet 2008; 371:1777.
- ↑ Tillil H, Köbberling J. Age-corrected empirical genetic risk estimates for first-degree relatives of IDDM patients. Diabetes 1987; 36:93.
- ↑ Krzewska, Aleksandra; Ben-Skowronek, Iwona (2016). "Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents". BioMed Research International. 2016: 1–12. doi:10.1155/2016/6219730. ISSN 2314-6133.
- ↑ Knip, Mikael; Siljander, Heli (2016). "The role of the intestinal microbiota in type 1 diabetes mellitus". Nature Reviews Endocrinology. 12 (3): 154–167. doi:10.1038/nrendo.2015.218. ISSN 1759-5029.
- ↑ 13.0 13.1 Writing Group for the SEARCH for Diabetes in Youth Study Group. Dabelea D, Bell RA, D'Agostino RB, Imperatore G, Johansen JM; et al. (2007). "Incidence of diabetes in youth in the United States". JAMA. 297 (24): 2716–24. doi:10.1001/jama.297.24.2716. PMID 17595272.
- ↑ Weets I, De Leeuw IH, Du Caju MV, Rooman R, Keymeulen B, Mathieu C; et al. (2002). "The incidence of type 1 diabetes in the age group 0-39 years has not increased in Antwerp (Belgium) between 1989 and 2000: evidence for earlier disease manifestation". Diabetes Care. 25 (5): 840–6. doi:10.2337/diacare.25.5.840. PMID 11978678.
- ↑ Xu, Guifeng; Liu, Buyun; Sun, Yangbo; Du, Yang; Snetselaar, Linda G; Hu, Frank B; Bao, Wei (2018). "Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study". BMJ: k1497. doi:10.1136/bmj.k1497. ISSN 0959-8138.
- ↑ Skrivarhaug, T.; Bangstad, H.-J.; Stene, L. C.; Sandvik, L.; Hanssen, K. F.; Joner, G. (2005). "Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway". Diabetologia. 49 (2): 298–305. doi:10.1007/s00125-005-0082-6. ISSN 0012-186X.
- ↑ 17.0 17.1 17.2 17.3 17.4 Maahs DM, West NA, Lawrence JM, Mayer-Davis EJ (2010). "Epidemiology of type 1 diabetes". Endocrinol Metab Clin North Am. 39 (3): 481–97. doi:10.1016/j.ecl.2010.05.011. PMC 2925303. PMID 20723815.
- ↑ "Variation and trends in incidence of childhood diabetes in Europe. EURODIAB ACE Study Group". Lancet. 355 (9207): 873–6. 2000. PMID 10752702.
- ↑ Haller MJ, Atkinson MA, Schatz D (2005). "Type 1 diabetes mellitus: etiology, presentation, and management". Pediatr Clin North Am. 52 (6): 1553–78. doi:10.1016/j.pcl.2005.07.006. PMID 16301083.
- ↑ Kyvik, K. O.; Nystrom, L.; Gorus, F.; Songini, M.; Oestman, J.; Castell, C.; Green, A.; Guyrus, E.; Ionescu-Tirgoviste, C.; McKinney, P. A.; Michalkova, D.; Ostrauskas, R.; Raymond, N. T. (2004). "The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children". Diabetologia. 47 (3): 377–384. doi:10.1007/s00125-004-1331-9. ISSN 0012-186X.
- [[#cite_ref-Blohm�Nystr�m1992_21-0|↑]] Blohm�, G.; Nystr�m, L.; Arnqvist, H. J.; Lithner, F.; Littorin, B.; Olsson, P. O.; Scherst�n, B.; Wibell, L.; �stman, J. (1992). "Male predominance of Type 1 (insulin-dependent) diabetes mellitus in young adults: results from a 5-year prospective nationwide study of the 15?34-year age group in Sweden". Diabetologia. 35 (1): 56–62. doi:10.1007/BF00400852. ISSN 0012-186X. replacement character in
|last2=at position 6 (help); replacement character in|last7=at position 8 (help); replacement character in|last9=at position 1 (help); replacement character in|last1=at position 6 (help) - ↑ Diaz-Valencia, Paula A; Bougnères, Pierre; Valleron, Alain-Jacques (2015). "Global epidemiology of type 1 diabetes in young adults and adults: a systematic review". BMC Public Health. 15 (1). doi:10.1186/s12889-015-1591-y. ISSN 1471-2458.
- ↑ Soltesz, G; Patterson, CC; Dahlquist, G (2007). "Worldwide childhood type 1 diabetes incidence ? what can we learn from epidemiology?". Pediatric Diabetes. 8 (s6): 6–14. doi:10.1111/j.1399-5448.2007.00280.x. ISSN 1399-543X.
- ↑ Cucca, Francesco; Goy, Juliet V.; Kawaguchi, Yoshihiko; Esposito, Laura; Merriman, Marilyn E.; Wilson, Amanda J.; Cordell, Heather J.; Bain, Stephen C.; Todd, John A. (1998). "A male-female bias in type 1 diabetes and linkage to chromosome Xp in MHC HLA-DR3-positive patients". Nature Genetics. 19 (3): 301–302. doi:10.1038/995. ISSN 1061-4036.
- ↑ Hyttinen, V.; Kaprio, J.; Kinnunen, L.; Koskenvuo, M.; Tuomilehto, J. (2003). "Genetic Liability of Type 1 Diabetes and the Onset Age Among 22,650 Young Finnish Twin Pairs: A Nationwide Follow-Up Study". Diabetes. 52 (4): 1052–1055. doi:10.2337/diabetes.52.4.1052. ISSN 0012-1797.
- ↑ Zalutskaya, A.; Mokhort, T.; Garmaev, D.; Bornstein, S. R. (2004). "Did the Chernobyl incident cause an increase in Type 1 diabetes mellitus incidence in children and adolescents?". Diabetologia. 47 (1): 147–148. doi:10.1007/s00125-003-1271-9. ISSN 0012-186X.