Increasing Incidence of Type I Diabetes in The Netherlands: The second nationwide study among children under 20 years of age
- Dirk Ruwaard, MD,
- Remy A Hirasing, MD, PHD,
- H Maarten Reeser, MD,
- Stef Van Buuren, MSC,
- Karel Bakker, MD, PHD,
- Rob J Heine, MD, PHD,
- Rolf A Geerdink, MD, PHD,
- G Jan Bruining, MD, PHD,
- Gerrit J Vaandrager, MD, PHD and
- S Pauline Verloove-Vanhorick, MD, PHD
- National Institute of Public Health and Environmental Protection Bilthoven
- TNO Institute of Preventive Health Care Leiden
- Juliana Children's Hospital The Hague
- Spaarne Hospital Heemstede Heemstede
- Department of Internal Medicine, Free University Hospital Amsterdam Amsterdam
- Dutch Diabetes Association Amersfoort
- Department of Pediatrics, Academic Hospital Rotterdam/Sophia Children/s Hospital Rotterdam, The Netherlands
- Address correspondence and reprint requests to Remy A. Hirasing, MD, PhD, TNO Institute of Preventive Health Care, Leiden, P. O. Box 124, 2300 AC Leiden, The Netherlands.
Abstract
OBJECTIVE A nationwide retrospective study was conducted to assess the incidence of type I diabetes in The Netherlands among children <20 years of age in 1988–1990. The first study with a similar design covered 1978–1980.
RESEARCH DESIGN AND METHODS The capture recapture census method was chosen for analysis of the data. A questionnaire was sent to all Dutch pediatricians and internists, and for the ascertainment, a similar questionnaire was sent out separately to members of the Dutch Diabetes Association, which is the national patient association.
RESULTS The average achieved ascertainment rate was 81%. The ascertainmentadjusted annual incidence was 13.2/100,000 for 0- to 19-year-old children, indicating an increase of 23% compared with the 1978–1980 survey; for 0- to 14-year-olds, the increase amounted to 17%.
CONCLUSIONS This study suggests a sustained increase of type I diabetes in The Netherlands because the cumulative incidence studied previously in the 1960–1970 birth cohorts of male army conscripts 18 years of age was also found to rise. In contrast to Northern European countries, an increase in incidence for the age category 0–4 years could not be found.
- Received July 12, 1993.
- Accepted December 9, 1993.
- Copyright © 1994 by the American Diabetes Association
