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Increasing incidence of type 1 diabetes between 1986 and 2015 in Bauru, Brazil
Carlos Antonio Negrato1, José Roberto Pereira Lauris2, Ieso Braz Saggioro1
1Bauru's Diabetics Association, Department of Internal Medicine, Bauru, São Paulo, Brazil.
Insights
Type 1 diabetes incidence in Brazilian children has significantly increased over thirty years. This study highlights Brazil as a country with a high type 1 diabetes rate, necessitating further research.
Area of Science:
- Epidemiology
- Pediatrics
- Endocrinology
Background:
- Type 1 diabetes (T1D) is a global health concern, with incidence rates varying significantly by geographic region.
- Understanding temporal trends in T1D incidence is crucial for public health planning and resource allocation.
Observation:
- This study analyzed T1D incidence in children up to 14 years old in Bauru, Brazil, from 1986 to 2015.
- A capture-recapture method and individual case notification were employed to ensure accurate data collection.
- The overall incidence was 12.8 per 100,000 person-years, with significant annual variations observed.
Findings:
- A substantial increase in T1D incidence was observed, rising approximately 3.1% annually over the 30-year period.
- The incidence rate showed a 9.1-fold variation, reaching a peak of 25.6 per 100,000 in 2013.
- Higher incidence rates were noted in older children (5-14 years) compared to younger children (0-4 years), and diagnoses peaked during colder months.
Implications:
- The findings indicate a high and increasing incidence of T1D in Brazil, positioning it as a country with a significant burden of the disease.
- Further research across all Brazilian regions is essential to identify contributing factors to T1D predisposition and its rising incidence.
- These insights can inform targeted prevention strategies and healthcare interventions for type 1 diabetes in Brazil.
Aims:
To assess temporal trends in the incidence of type 1 diabetes in Bauru, São Paulo State, Brazil from 1986 to 2015.
Research Design And Methods:
The yearly incidence of type 1 diabetes (per 100,000/yr) from 1986 to 2015 was determined in children ≤14yr of age, using individual case notification and the capture and recapture method.
Results:
During thirty years (1986-2015), 302 cases were diagnosed in our population. The overall incidence was of 12.8/100,000 (95% CI: 11.2-14.4), ranging from 2.8/100,000 in 1987 to 25.6/100,000 in 2013 with a 9.1-fold variation. It was non-significantly higher in girls [13.7 (95% CI: 11.4-16.1)] than in boys [12.0 (95% CI: 9.8-14.2)] (p=0.48) and significantly higher in the 5-9yr [14.6 (95% CI: 11.8-17.4)] and 10-14yr [15.8 (95% CI: 12.7-18.8)] age ranges compared to the 0-4yr [8.1 (95% CI: 6.0-10.2)] age range (p<0.001). The majority of diagnoses were made in colder months. The patterns of incidence were very high and high in 80.0% of the study-years.
Conclusions:
The incidence of type1 diabetes in children ≤14yr has increased in Bauru, Brazil, in the last thirty years, in approximately 3.1% annually, with an absolute crude increase of 2.5-fold. These findings pose Brazil as a country with high incidence of type 1 diabetes. All Brazilian regions should be enrolled in future studies to determine the factors that contribute to the predisposition to type 1 diabetes in our population and to the steep rise in its incidence.