http://www.pedresearch.org/cgi/content/abstract/52/6/859
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Pediatric Research 52:859-862 (2002)
© 2002 International
Pediatric Research Foundation, Inc.
DOI: 10.1203/01.PDR.0000034261.44203.26
INSERM U 457, Robert Debré Hospital, Paris, France
Correspondence: Claire Lévy-Marchal, INSERM U 457, Robert Debré Hospital, 48 boulevard Sérurier, F75019 Paris, France; e-mail: clairelm@idf.inserm.fr
The objective was to test whether the pattern of increase in
incidence of type I diabetes in children under 20 y of age varies
with age at onset in France during 1988–1997. The French
register of insulin-dependent diabetes was based on the direct
identification of new cases by a prospective registration in children
under the age of 20 y. Data from the French Social Security were used
as a secondary independent source of cases. The rate of ascertainment
was 
95% over the 10-y period studied.
Data were analyzed using linear regression; departure from a
linear trend was tested in each age group. A total of 1867 children
under 20 y of age at the time of diagnosis were included. The
incidence rate of type I diabetes in children rose significantly
between 1988 and 1997, from 7.41 per 100,000 per year (95% confidence
interval: 6.55–8.27) to 9.58 per 100,000 per year (95% confidence
interval: 8.64–10.52) with p = 0.0001. The percentage increase
was greates in the 0–4 y age group, with a significant departure from
linear trend (p = 0.036), reflecting an acceleration of the
increase. Incidence rates rose linearly in 5–9 y (average increase
0.43 per 100,000 per year, p = 0.011) and 10–14 y (average
increase 0.40 per 100,000 per year, p = 0.002) age groups,
whereas it remained stable in the 15–19 y age group (p =
0.77). The incidence rate was significantly higher in boys than in
girls (p = 0.005), but the rise in incidence did not differ
between the two genders. The rise in incidence of type I diabetes in
France was of the same magnitude as observed in the rest of Europe
over 10 y. A specific pattern was observed in children under 5 y of
age, contrasting with stable rates over 15 y. These data suggest
a shift toward a younger age at onset of type I diabetes in
childhood, contributing, at least in part, to the observed increase
in incidence of type I diabetes in children.
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Copyright © 2002 by the International Pediatric Research Foundation.
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