Evidence of a plateau in the incidence of type 1 diabetes in children 0–4 years of age from a regional pediatric diabetes center; Auckland, New Zealand: 1977–2019. Issue 6 (4th June 2021)

• Record Type: Journal Article
• Authors: Flint, Samuel A.; Gunn, Alistair J.; Hofman, Paul L.; Cutfield, Wayne S.; Han, Dug Yeo; Mouat, Fran; Willis, Jinny; Jefferies, Craig A.
• Is Part Of: Pediatric diabetes. Volume 22:Issue 6(2021)
• Page Start: 854
• Page End: 860
• Publication Date: 2021-06-04
• Subjects: childhood -- epidemiology -- ethnicity -- incidence -- type 1 diabetes mellitus; Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.13236
• Languages: English
• ISSNs: 1399-543X

Abstract

Abstract: Objective: To determine the incidence of new onset type 1 diabetes in children aged 0–14 years from 1977 to 2019 in Auckland, New Zealand. Research design and methods: A cohort study of children with type 1 diabetes aged 0–14 years ( n = 1688; 50.4% male) managed by the regional diabetes service between 1977 and 2019. Incidence rates were estimated using census data. Results: The incidence of type 1 diabetes increased by 2.9%/year from 1977 to 2006 (95% confidence interval [CI] 2.13% – 3.48%). Although there was no significant change from 2006 to 2019 (−0.3%/year, 95% CI ‐1.62% – 1.08%), there was a dramatic fall from 1976 to 2018 in the proportion of New Zealand Europeans, from 69.9 to 33.9%. New Zealand Europeans had the highest incidence (23.3/100, 000, 95% CI 20.6–26.1) compared to Māori (8.3/100, 000, 95% CI 6.3–10.2), Pasifika (8.6/100, 000, 95% CI 6.9–10.4) and other (6.4/100, 000, 95% CI 4.7–8.0). All groups showed an overall increase in incidence over time, Māori 4.4%/year, Pasifika 3.7%, compared to New Zealand European 2.7%, and other 2.1%. Incidence increased consistently in 5–9 and 10–14 year olds (2.0% and 2.2%/year, respectively). By contrast, whereas 0–4 year olds showed an increase of 4.6%/year from 1977 to 2003 (p < 0.01), there was no change from 2003 to 2019 (p = 0.2). Conclusion: There has been a plateau in the incidence of type 1 diabetes in children 0–4 years of age in the Auckland region since 2003, but not older children. The apparent plateau in the overall incidence of new onset type 1 diabetes in children 0–14 years since 2006 was mediated by substantial changes in the ethnic makeup of the Auckland region.