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Pediatr Diabetes. 2013 Mar;14(2):138-48. doi: 10.1111/j.1399-5448.2012.00904.x. Epub 2012 Aug 28.

Type I diabetes among children and young adults: the role of country of birth, socioeconomic position and sex.

Author information

  • 1Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, Box 210, SE-171 77, Stockholm, Sweden. Hozan.Hussen@ki.se

Abstract

OBJECTIVE:

To investigate associations between country of birth, parental country of birth, and education with respect to incidence rate and time trends of type 1 diabetes mellitus (T1DM) among children and young adults.

METHODS:

We followed a nation-wide cohort of 4 469 671 males and 4 231 680 females aged 0-30 years between 1969 and 2008. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) for T1DM were calculated using Poisson regression models. We further calculated age-standardized rates (ASRs) of T1DM, using the world population as standard.

RESULTS:

During the study period, the ASR of T1DM increased among children younger than 15 years, but not among young adults (15-30 years). Compared with Swedish-born children, male and female immigrant children had 44 and 42% lower IRR of TIDM, respectively. Among offspring to immigrants, corresponding decreases in IRRs were 27 and 24%, respectively. Compared with children to parents with high education, male children to parents with low education had a 10% decreased IRR of T1DM, while no effect was observed among females. The IRR of T1DM increased with increasing age and calendar time of follow-up in both sexes (p-for trend <0.0001). In young adults, the IRR among immigrants decreased by 32% in males and 22% in females, while corresponding reductions in IRRs were less in offspring to immigrants.

CONCLUSIONS:

We found a lower IRR of T1DM among offspring to immigrants, but especially among young immigrants compared with Sweden-born individuals. The findings show that environmental factors are important in the etiology of T1DM.

© 2012 John Wiley & Sons A/S.

PMID:
22925403
[PubMed - indexed for MEDLINE]
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