Auckland Medical School, University of Auckland, Auckland, New Zealand.
Department of Physiology, University of Auckland, Auckland, New Zealand.
Pediatr Diabetes. 2021 Sep;22(6):854-860. doi: 10.1111/pedi.13236. Epub 2021 Jun 4.
To determine the incidence of new onset type 1 diabetes in children aged 0-14 years from 1977 to 2019 in Auckland, New Zealand.
A cohort study of children with type 1 diabetes aged 0-14 years (n = 1688; 50.4% male) managed by the regional diabetes service between 1977 and 2019. Incidence rates were estimated using census data.
The incidence of type 1 diabetes increased by 2.9%/year from 1977 to 2006 (95% confidence interval [CI] 2.13% - 3.48%). Although there was no significant change from 2006 to 2019 (-0.3%/year, 95% CI -1.62% - 1.08%), there was a dramatic fall from 1976 to 2018 in the proportion of New Zealand Europeans, from 69.9 to 33.9%. New Zealand Europeans had the highest incidence (23.3/100,000, 95% CI 20.6-26.1) compared to Māori (8.3/100,000, 95% CI 6.3-10.2), Pasifika (8.6/100,000, 95% CI 6.9-10.4) and other (6.4/100,000, 95% CI 4.7-8.0). All groups showed an overall increase in incidence over time, Māori 4.4%/year, Pasifika 3.7%, compared to New Zealand European 2.7%, and other 2.1%. Incidence increased consistently in 5-9 and 10-14 year olds (2.0% and 2.2%/year, respectively). By contrast, whereas 0-4 year olds showed an increase of 4.6%/year from 1977 to 2003 (p < 0.01), there was no change from 2003 to 2019 (p = 0.2).
There has been a plateau in the incidence of type 1 diabetes in children 0-4 years of age in the Auckland region since 2003, but not older children. The apparent plateau in the overall incidence of new onset type 1 diabetes in children 0-14 years since 2006 was mediated by substantial changes in the ethnic makeup of the Auckland region.
确定新西兰奥克兰市 1977 年至 2019 年间 0-14 岁儿童新发 1 型糖尿病的发病率。
对 1977 年至 2019 年间通过区域糖尿病服务机构管理的 0-14 岁（50.4%为男性）1 型糖尿病患儿进行队列研究（n=1688；50.4%为男性）。使用人口普查数据估计发病率。
1977 年至 2006 年间，1 型糖尿病的发病率每年增长 2.9%（95%置信区间[CI]为 2.13%至 3.48%）。尽管 2006 年至 2019 年期间发病率无明显变化（-0.3%/年，95%CI-1.62%至 1.08%），但 1976 年至 2018 年，新西兰欧洲裔人群的比例从 69.9%急剧下降至 33.9%。新西兰欧洲裔人群的发病率最高（23.3/100,000，95%CI 20.6-26.1），其次是毛利人（8.3/100,000，95%CI 6.3-10.2）、太平洋岛民（8.6/100,000，95%CI 6.9-10.4）和其他族裔（6.4/100,000，95%CI 4.7-8.0）。所有人群的发病率均随时间呈总体上升趋势，毛利人发病率每年上升 4.4%，太平洋岛民上升 3.7%，新西兰欧洲裔上升 2.7%，其他族裔上升 2.1%。5-9 岁和 10-14 岁儿童的发病率持续上升（分别为 2.0%和 2.2%/年）。相比之下，0-4 岁儿童的发病率从 1977 年至 2003 年期间每年增长 4.6%（p<0.01），但 2003 年至 2019 年期间无变化（p=0.2）。
自 2003 年以来，奥克兰地区 0-4 岁儿童 1 型糖尿病的发病率已达到平台期，但年龄较大的儿童的发病率仍在上升。自 2006 年以来，0-14 岁儿童新发 1 型糖尿病的总体发病率似乎达到了平台期，这是由于奥克兰地区种族构成发生了重大变化。
