Metcalfe M A, Baum J D
Institute of Child Health, Royal Hospital for Sick Children, Bristol.
BMJ. 1991 Feb 23;302(6774):443-7. doi: 10.1136/bmj.302.6774.443.
To ascertain the annual incidence rate of insulin dependent diabetes diagnosed in children under the age of 15 years in the British Isles during 1988, and to compare the results with an earlier study carried out in 1973-4.
Active monthly reporting of cases by consultant paediatricians, with additional input from diabetologists and all specialist diabetes nurses and health visitors.
British Isles (England, Wales, Scotland, Northern Ireland, Republic of Ireland) with a total population at risk of 11,819,000 children.
All children diagnosed under the age of 15 years with primary insulin dependent diabetes from 1 January to 31 December 1988 and resident in the British Isles at diagnosis.
National incidence rate of insulin dependent diabetes; differences in incidence rates between regions and between three age groups: 4 and under, 5-9, and 10-14 year olds.
1600 children (837 boys and 763 girls) had a confirmed diagnosis of insulin dependent diabetes, giving a national incidence rate of 13.5/100,000/year (95% confidence interval 12.9 to 14.2/100,000/year). This was considerably higher than the incidence rate of 7.7/100,000/year in children under the age of 16 years reported in the British Diabetic Association's study of 1973-4. The age-sex adjusted rates varied between regions, ranging from 6.8/100,000/year (Republic of Ireland) to 19.8/100,000/year (Scotland). There were considerable differences in the numbers of cases diagnosed each month, with the 10-14 year age group showing the most seasonal variation. A quarter of the children (404/1600) were under 5 years old. Case ascertainment was estimated as 90%.
Insulin dependent diabetes in the British Isles does not seem to occur uniformly over time or geographical area. Even allowing for differences in ascertainment between the 1973-4 and 1988 studies, there seems to have been an increase in the incidence rate of insulin dependent diabetes in children under the age of 15 years during the 15 year time period. If diabetes is becoming more common in this age group, possibly by developing earlier in susceptible children, this would be a matter of considerable public health concern.
确定1988年不列颠群岛15岁以下儿童中确诊的胰岛素依赖型糖尿病的年发病率，并将结果与1973 - 1974年进行的早期研究进行比较。
儿科顾问医生每月主动报告病例，并由糖尿病专家、所有专科糖尿病护士和健康访视员提供补充信息。
不列颠群岛（英格兰、威尔士、苏格兰、北爱尔兰、爱尔兰共和国），有1181.9万名儿童面临患病风险。
1988年1月1日至12月31日期间确诊的所有15岁以下原发性胰岛素依赖型糖尿病儿童，确诊时居住在不列颠群岛。
胰岛素依赖型糖尿病的全国发病率；不同地区以及三个年龄组（4岁及以下、5 - 9岁、10 - 14岁）之间发病率的差异。
1600名儿童（837名男孩和763名女孩）确诊为胰岛素依赖型糖尿病，全国发病率为13.5/100,000/年（95%置信区间为12.9至14.2/100,000/年）。这显著高于英国糖尿病协会1973 - 1974年研究报告的16岁以下儿童7.7/100,000/年的发病率。年龄 - 性别调整后的发病率在不同地区有所不同，从6.8/100,000/年（爱尔兰共和国）到19.8/100,000/年（苏格兰）。每月确诊的病例数存在显著差异，10 - 14岁年龄组的季节性变化最为明显。四分之一的儿童（404/1600）年龄在5岁以下。病例确诊率估计为90%。
不列颠群岛的胰岛素依赖型糖尿病在时间和地理区域上似乎并非均匀发生。即使考虑到1973 - 1974年和1988年研究在确诊方面的差异，在这15年期间，15岁以下儿童胰岛素依赖型糖尿病的发病率似乎有所上升。如果糖尿病在这个年龄组中变得更加普遍，可能是易感儿童发病更早，这将是一个相当值得关注的公共卫生问题。
