An increase in the prevalence of type 1 and 2 diabetes in children and adolescents: results from prescription data from a UK general practice database

Abstract

What is already known about this subject: Increasing antidiabetic drugs use in youths has been reported in the USA, however there is a lack of epidemiological evidence in the UK. There is an increase in the prevalence of both type 1 and 2 diabetes, but precise estimates are difficult to obtain and as such are uninformative for future health services planning.

What this study adds: The prevalence of children receiving insulin and oral antidiabetic drugs has increased twofold and eightfold, respectively, between 1998 and 2005. The data reflect the prevalence of both type 1 and type 2 diabetes rapidly increase in recent years. The prevalence of antidiabetic drug use increases with increasing age, especially among those aged 12-18 years. Consideration needs to be given to the funding and design of future services for children and particularly adolescents with diabetes to take account of these epidemiological findings.

Aims: Despite evidence of an increase in the incidence of both type 1 and type 2 diabetes in youths, there are few data on the prevalence of either type in children and adolescents. The aim of this study was to investigate the prevalence of childhood diabetes over an 8-year period in the UK.

Methods: This was a retrospective cohort study that covered 8 years (January 1998 to December 2005) of UK IMS Disease Analyzer (IMS DA) data. The cohort comprised all children and adolescents aged 0-18 years who received at least one antidiabetic drug prescription during the study period. The prevalence of antidiabetic drug prescribing was used as a proxy for diabetes itself.

Results: Data were available on 505 754 children aged 0-18 years and a total of 37 225 antidiabetic prescriptions were issued. Insulin use increased significantly from 1.08 per 1000 children [95% confidence interval (CI) 0.96, 1.20] in 1998 to 1.98 (95% CI 1.80, 2.10) in 2005 (P < 0.001), more markedly in those aged 12 and 18 years. The use of oral antidiabetic drugs for diabetes treatment rose significantly from 0.006 per 1000 children in 1998 (95% CI 0.0043, 0.017) to 0.05 (95% CI 0.025, 0.080) (P < 0.001) in 2005.

Conclusions: This study indicates a significant increase in prevalence on both type 1 and type 2 diabetes treatment in children and adolescents in the UK. Thus, this supporting evidence from other sources that the prevalence of childhood diabetes is rising rapidly. Further epidemiological studies are required to investigate the aetiology and risk factors.

Figure 1

Overall prevalence of antidiabetic drug use in children and adolescents by age on IMS DA, 1998–2005 inclusive. girls (); boys (); overall ()

Figure 3

Prevalence of insulin use by age groups between 1998 and 2005 in the IMS DA (with 95% CIs). 0–1 years (); 2–5 years (); 6–11 years* (); 12–18 years* (); *a significant trend for increasing use (p < 0.001)

Figure 2

Prevalence of insulin, oral antidiabetic drugs and oral antidiabetic drugs with a diabetes indication amongst children and adolescents aged 0–18 (with 95% CIs). insulin* (); oral antidiabetic drugs* (); oral antidiabetic drugs with diabetes indication* (); *a significant trend for increasing use (p < 0.001)

Figure 4

Prevalence of insulin use by age groups between 1998 and 2005 in the General Practice Research Database (GPRD) (with 95% CIs). 0–1 years (); 2–5 years (); 6–11 years* (); 12–18 years* (); *a significant trend for increasing use (p < 0.001)