EPIDEMIOLOGY OF THE IDDM IN GERMANY

In many European countries, the incidence of Insulin Dependent Diabete s Mellitus (IDDM) among children and adolescents is observed to be rai sing. The rapid increase cannot be explained solely by changes in the genetic pool. The assumption of an increased exposure of children to v ariable risk factors from the environment (eating behaviors, life-styl e factors, ecological influences) offers a more plausible explanation. The hypothesis of non-genetical factors to be associated with the ris k of IDDM is backed by the results of ecological studies and first evi dence from case-control-studies. Data on the incidence of IDDM in chil dhood and adolescents in Germany are not available. Since July 1st, 19 92, new cases of IDDM in children under fice years of age have been in cluded into the list of diseases, registered by the ''Surveillance Uni t for Rare Pediatric Diseases in Germany'' (ESPED). The data will be u sed to estimate the national age-specific incidence, and to assess eve ntual regional variation within the country. Based on the cases report ed to ESPED, a case control study will investigate the effect of sever al non-hereditary risk factors on the IDDM-risk of children unter 5 ye ars in Germany. Data on the incidence of IDDM will be useful in health -planning; knowledge of the attributable isks associated with specific risk factors is a prerequisite for the planning of prevention strateg ies.