Trends in Incidence Rates during 1999-2008 and Prevalence in 2008 of Childhood Type 1 Diabetes Mellitus in GERMANY - Model-Based National Estimates

Aims To estimate the national incidence rate and trend of type 1 diabetes (T1DM) in Germany from 1999 to 2008 and the national prevalence in 2008 in the age group 0-14 years. Methods Data were taken from a nationwide registry for incident cases of T1DM in the ages 0-4 years and 3 regional registries (North-Rhine-Westphalia, Baden-Wuerttemberg and Saxony) for incident cases of T1DM in the ages 0-14 years covering 41% of the child population in Germany. The degree of ascertainment was >= 97% in all registries. Incident and prevalent cases were grouped by region, sex, age (0-4, 5-9, 10-14 years), and, for incident data, additionally by two 5-year periods (1999-2003, 2004-2008). Poisson regression models were fitted to the data to derive national estimates of incidence rate trends and prevalence in the age groups 5-9, 10-14 and 0-14 years. We used direct age-standardization. Results The estimated national incidence rate in 0-14-year-olds increased significantly by 18.1% (95% CI: 11.6-25.0%, p<0.001) from 1999-2003 to 2004-2008, independent of sex, corresponding to an average annual increase of 3.4% (95%-CI: 2.2-4.6%). The overall incidence rate was estimated at 22.9 per 100,000 person-years and we identified a within-country west-east-gradient previously unknown. The national prevalence in the ages 0-14 years on 31/12/2008 was estimated to be 148.1 per 100,000 persons. Conclusions The national incidence rate of childhood T1DM in Germany is higher than in many other countries around the world. Importantly, the estimated trend of the incidence rate confirms the international data of a global increase of T1DM incidences.