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Pediatr Diabetes. 2019 Oct 19. doi: 10.1111/pedi.12937. [Epub ahead of print]

Mandatory notifications of type 1 diabetes incident cases in Chilean children, 2006 to 2014: A population-based study.

Author information

1
Division of Pediatrics, Pontificia Universidad Católica de Chile School of Medicine, Santiago, Chile.
2
Pediatric Endocrinology Unit, Universidad de Los Andes, Santiago, Chile.
3
Millennium Institute on Immunology and Immunotherapy, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
4
School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

Abstract

Type 1 diabetes mellitus (T1D) incidence in children varies across regions and countries, showing a continuous rise globally. Chile has mandatory T1D notification and guaranteed access to diagnosis and treatment since 2005, providing a strong model to evaluate T1D epidemiology.

OBJECTIVE:

To determine T1D incidence in Chilean population under 20 years between 2006 and 2014.

METHODS:

We reviewed mandatory notifications of T1D in Chile's public health system.

RESULTS:

A total of 4153 T1D cases in population under 20 years were notified from 2006 to 2014. Median age was 14 years and 51% were male. The average annual T1D incidence was 12 per 100 000 population, with an increase from 10.2 in 2006 to 13.8 in 2014 (β 0.5 95% confidence interval [CI] 0.4-0.7, P < .001). A significantly increasing linear trend of T1D incidence was observed in groups of 0 to 4 years (β 0.33, 95% CI 0.06-0.59, P = .02), 5 to 9 years (β 0.68 95% CI 0.27-1.10, P = .006), and 10 to 14 (β 0.94, 95% CI 0.67-1.20, P < .001), but increase was less pronounced in the oldest children aged between 15 and 19 years (β 0.22, 95% CI -0.03 to 0.44, P = .052). The lowest regional T1D incidence was observed in the Araucanía region, which has the highest rate of indigenous population.

CONCLUSION:

Incidence rates of T1D in Chile, evaluated through a mandatory notification program, are rapidly increasing in children and adolescents. If increasing trends persist, Chile will reach T1D incidence rates of Western developed countries in the next decade.

KEYWORDS:

Chile; diabetes mellitus; epidemiology; incidence; type 1 diabetes

PMID:
31628775
DOI:
10.1111/pedi.12937

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