engleski

An increase in the incidence of type 1 diabetes in children aged less than 15 years in Croatia is still continuing in the period from 2004 to 2009

Introduction. The incidence of type 1 diabetes mellitus (T1DM) has increased markedly during the last fifty years among children and adolescents, while mean age at diagnosis has decreased. It was studied in Croatian children and adolescents under the age of 15 years during the period from 1995 to 2003 when it was 8.87 per 100.000/person-years, which placed Croatia in a group of countries with moderate risk for T1DM according to WHO. Objectives. To determine incidence rates of T1DM in children and adolescents younger than 15 years in Croatia in the period from 2004 to 2009, to evaluate additional differences in incidence rates and trends and to compare them with results from the study that analysed the period of 1995 to 2003 in Croatia, and with data from other European countries. Patients and methodes. The number of newly diagnosed T1DM patients was achieved from registry that collects data from all pediatric departments in Croatia. The population data were obtained from Central Bureau of Statistics of the Republic of Croatia. T1DM crude incidence rates were estimated as a number of newly diagnosed patients per 100.000 persons per year, among all children aged 0 to 14 years, and in three age subgroups: 0 to 4, 5 to 9 and 10 to 14 years old. The method of direct standardization to WHO standard world population of less than 15 years of age was used for calculation of standardized incidence according to gender and as a whole group. Poisson regression model was used to analyse the incidence rates by gender, age, and calendar year, and their interactions. Results. During the period of six years 665 children (364 girls, 319 boys) aged 0 to 14 years were diagnosed for T1DM. The standardized incidence was 15.71 (95% CI 9.51-21.91) per 100 000/person-year. No significant difference in T1DM incidence was found between boys and girls (2 =2.83 ; p>0.05). The annual increase in incidence was 5.44% (95% CI 0.84-10.24) and was statistically significant (2 =5.087, p<0.02). When analized by age-groups, the increase in incidence was statistically significant only in the group of 5-9 years old children 11.17% 95% CI (3.17–19.79) ; 2 =7.73 ; p<0.005. In the 10- 14 years old age group the increase of 4, 72% (95% CI -2, 28–12, 22) was not statistically significant. In the 0-4 years old age group the trend was negative, -1.78% (95% CI -10.56-7.83) and not statistically significant. The trend in incidence did not differ significantly between boys and girls. Conclusion. The incidence of T1DM in children and adolescents under the age of 15 years in Croatia is still increasing and is calculated to be 15, 71 per 100 000/person- year , which now places Croatia in a group of countries with high risk for T1DM. The incidence trend further increased significantly with an average annual raise of 5.44%, that was markedly lower than in previous study (1995-2003 ; 9.0%), but still higher than European average (3.9%).

type 1 diabetes, incidence, children

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