Diabetes incidence in children of different nationalities: an epidemiological approach to the pathogenesis of diabetes

Aims/hypothesis. Incidence studies of children with Type I (insulin-depende nt) diabetes mellitus and different ethnic backgrounds are known to provide important insights into the pathogenesis of the disease. For this reason, we compared the incidence rate in Baden-Wurttemberg. Germany, of children w ho were not of German descent with that of German children as well as with the reported incidence rates pertaining to the countries of origin of the c hildren who were not of German descent. Methods. Our study was based on the Baden-Wurttemberg incidence register, p art of the EURODIAB TIGER network, which includes 2121 children aged 0-14 y ears, diagnosed as having Type I diabetes between 1987 and 1997. The study covered a population at risk of 1.8 million children, which represents 13.3 % of the total number of children in Germany. Results. The total incidence rate was found to be 12.5 per 100 000 per year (95%-CI 12.0-13.0); for German children alone it was calculated as 13.5 (9 5%-CI 12.9-14.1) and for children who were not of German descent it was sig nificantly lower at 6.9 per 100 000 per year (95%-Cl 5.8-8.0). The percenta ge of children who were not of German descent with Type I diabetes (8.3%) i s smaller than that among the general population (15.2%). Children from for mer Yugoslavia, Italy and Greece had incidence rates closer to their countr ies of origin than to the incidence rate of German children. Conclusion/interpretation. Our findings indicate that genetic factors play a predominant role in the pathogenesis of Type I diabetes. However, the inf luence of certain aspects of life-style, which remain constant even after i mmigration, cannot be excluded.