Variation and trends in incidence of childhood diabetes in Europe

Background To study the epidemiology of childhood-onset type 1 insulin-depe ndent diabetes in Europe, the EURODIAB collaborative group established in 1 988 prospective geographically-defined registers of new cases diagnosed und er 15 years of age. This report is based on 16 362 cases registered during the period 1989-94 by 44 centres representing most European countries and I srael and covering a population of about 28 million children. Methods Multiple sources of ascertainment were used in most centres to Vali date the completeness of registration by the capture-recapture method. Tren ds in incidence during the period were analysed by Poisson regression, the data from centres within each country being pooled. Findings The standardised average annual incidence rate during the period 1 989-94 ranged from 3.2 cases per 100 000 per year in the Former Yugoslav Re public of Macedonia to 40.2 cases per 100 000 per year in two regions of Fi nland. By pooling over all centres, the annual rate of increase in incidenc e was 3.4% (95% CI 2.5-4.4%), but in some central European countries it was more rapid than this. Pooled over centres and sexes, the rates of increase were 6.3% (4.1-8.5%) for children aged 0-4 years, 3.1% (1.5-4.8%) for 5-9 years, and 2.4% (1.0-3.8%) for 10-14 years. Interpretation The results confirm a very wide range of incidence rates wit hin Europe and show that the increase in incidence during the period varied from country to country. The rapid rate of increase in children aged under 5 years is of particular concern.