Trends in the incidence of type 1 diabetes and type 2 diabetes in children and adolescents in North Rhine-Westphalia, Germany, from 2002 to 2022 - 31/07/24

Doi : 10.1016/j.diabet.2024.101567

Anna Stahl-Pehe ^1,^2,^⁎ , Christina Baechle ^1,², Stefanie Lanzinger ^2,³, Michael S. Urschitz ⁴, Christina Reinauer ⁵, Clemens Kamrath ⁶, Reinhard W. Holl ^2,³, Joachim Rosenbauer ^1,²
¹ Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
² German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
³ Institute of Epidemiology and Medical Biometry, CAQM, Ulm University, Ulm, Germany
⁴ German Paediatric Surveillance Unit, Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
⁵ Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Düsseldorf, Germany
⁶ Department of General Pediatrics, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, University of Freiburg, Freiburg, Germany

^⁎Correspondence: Anna Stahl-Pehe, Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Germany Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany. Phone: +49 211 3382 410Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfGermany Auf'm Hennekamp 65DüsseldorfD-40225Germany

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Abstract

Aims

The objective of this study was to assess overall and segmented trends in the incidence of type 1 diabetes mellitus (T1DMM) and type 2 diabetes mellitus (T2DMM) in children and adolescents younger than 20 years, from 2002–2022.

Methods

This study used registry data on physician-diagnosed T1DM or T2DM from primary and secondary sources, covering the German federal state of North Rhine-Westphalia with 18 million inhabitants. The ages at T1DM and T2DM onset ranged from 0–19 and 10–19 years, respectively. The main outcomes were direct age- and/or sex-standardized incidence rates per 100,000 person-years (PYs) and trends estimated as annual percentage changes (APCs), both with 95% confidence intervals. The segmented trends for subperiods were based on joinpoint regression models.

Results

From 2002–2022, 17,470 and 819 persons had incident T1DM and T2DM, respectively. The total number of PYs was 73,743,982 for T1DM and 39,210,453 for T2DM, with a mean coverage rate of 98% for T1DM and 90% for T2DM. The standardized T1DM incidence increased from 17.6 [16.3;18.9} in 2002 to 33.2 [31.3;35.1] in 2022, with an APC of 2.7% [2.3%;3.1%]. The standardized T2DM incidence increased from 1.3 [0.8;1.7] in 2002 to 2.8 [2.0;3.6] in 2022, with an APC of 6.4% [4.9%;8.0%]. There were four different segmented trends for T1DM and T2DM, with the incidence peaking in 2021 and subsequently declining.