Type 1 Diabetes cases in children under five set to double by 2020

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Cases of type 1 diabetes in children under five look set to double by 2020 according to a Queen's University academic.

Dr Chris Patterson, from the Epidemiology Research Group at the Centre for Public Health at Queen's, jointly led the research published in the on-line version of the medical journal The Lancet today.

By studying data involving nearly 30,000 children across Europe the group also found that, if present trends continue, diagnoses of older children with the condition will also increase substantially.

Type 1 diabetes is caused by insulin deficiency and is treated with insulin injections, whereas type 2 diabetes is caused by reduced sensitivity to insulin along with some insulin deficiency and is more commonly controlled by diet or tablets.

In the general population, type 1 diabetes represents only a small proportion of total diabetes cases but among children, there are many more cases of type 1 diabetes than type 2 in European countries.

Although obesity is known to be a major risk factor for type 2 diabetes, it’s of little relevance to type 1. As no major environmental risk factors have been identified for type 1 diabetes there is no clear medical advice on how to prevent it.

To predict the future burden to health services of type 1 diabetes, the authors analysed diabetes data from 29,311 cases across 17 European countries, recorded between 1989 and 2003.

Dr Patterson, who is based in the School of Medicine, Dentistry and Biomedical Sciences at Queen’s, worked on the paper with academics from Hungary, Denmark and Sweden.

He said: “The changes over time are so rapid that they clearly cannot be because of genetic factors alone.

“Modern lifestyle habits such as increased weight and height in infancy, women having children later and greater numbers of caesarean section births may be possible contributory factors.

“However, these risk factors are too weak to explain anything more than a small part of the rise in incidence rates that has been observed in the 15 year period of the study.

“The highest rates of increases are seen in Eastern European countries which currently have the lowest incidence rates and where lifestyle habits are also changing more rapidly than in the more affluent European countries.”

The researchers found that the overall increase in incidence of type 1 diabetes was 3.9 per cent per year, while the annual increase in the birth to four years age group was 5.4 per cent, with a 4.3 per cent rise in the five to nine years age group, and a 2.9 per cent rise in 10 to14 year-olds.

Dr Patterson explained: “A younger age of onset of type 1 diabetes is concerning because it is usually associated with more acute symptoms including potentially life-threatening ketoacidosis*.

“Some of the most serious complications of diabetes which include blindness, heart disease renal disease, are likely to occur in younger ages in patients.”

There were estimated to have been around 15,000 new cases in children under 15 in Europe in 2005.

This total is predicted to increase to 24,400 new cases in 2020, with a doubling in the number of cases in children aged under five, from under 10,000 in 2005 to just over 20,000 in 2020.

If present trends continue, the total number of new and existing cases in European children under 15 years is predicted to rise from 94,000 in 2005 to 160,000 in 2020 — a 70% increase.

Dr Patterson added: “In the absence of any effective means to prevent type 1 diabetes, European countries need to ensure appropriate planning of services and that resources are in place to provide high-quality care for the increased numbers of children who will be diagnosed with diabetes in future years.”