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Comparative Study
. 2016 Aug;91(8):1066-73.
doi: 10.1016/j.mayocp.2016.05.019.

Incidence of Type 1 Diabetes Is Not Increasing in a Population-Based Cohort in Olmsted County, Minnesota, USA

Amanda K Cartee  1 , Lisa A Owens  1 , Brian D Lahr  2 , Barbara P Yawn  3 , Joseph A Murray  4 , Yogish C Kudva  5
Affiliations
Comparative Study

Incidence of Type 1 Diabetes Is Not Increasing in a Population-Based Cohort in Olmsted County, Minnesota, USA

Amanda K Cartee et al. Mayo Clin Proc. 2016 Aug.

Abstract

Objectives: To investigate the recent incidence of T1D in a US Midwestern county to determine whether this increase has been sustained and compare it with the incidence of celiac disease (CD) and also investigate the prevalence of CD, an associated autoimmune disease, within the cohort.

Patients and methods: A broad search strategy was used to identify all incident cases of T1D in Olmsted County, Minnesota, between January 1, 1994, and December 31, 2010, using the Rochester Epidemiology Project. Diagnosis and residency status were confirmed through the medical record. Incidence rates were directly standardized to the 2010 US population. Poisson regression was used to test for a change in incidence rate. Clinical charts were reviewed to confirm case status.

Results: There were 233 incident cases of T1D. Directly adjusting for age and sex with respect to the 2010 US white population, the overall annual incidence of T1D was 9.2 (95% CI, 8.0-10.4) per 100,000 people per year among all ages and 19.9 (95% CI, 16.6-23.2) per 100,000 people per year for those younger than 20 years. There was no significant increase in the incidence of T1D over time (P=.45). Despite the overall stability in annual incidence, there was an initial increasing trend followed by a plateau. Of the 109 patients with T1D (47%) tested for CD, 12% (13) had biopsy-proven CD.

Conclusion: The incidence of T1D has stopped increasing in Olmsted County, Minnesota, in the most recent decade. Further studies are needed to confirm this finding and explore reasons for this plateau.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Trends in Incidence of Type 1 Diabetes in Olmsted County, Minnesota, 1994-2010. A, Incidence of T1D overall and in those younger than 20 years. Loess-estimated curves depict smoothed trends in incidence (and 95% confidence bands) from the data defined according to granular strata; symbols reflect annual rates summarized across both sexes and the entire age range. B, T1D incidence by age and sex. Symbols represent sex-specific rates summarized by groupings of age: 0-4, 5-9, 10-14, 15-19, 20-29, and 30-39 years (older age groups were omitted because of very low incidence).
Figure 1
Figure 1
Trends in Incidence of Type 1 Diabetes in Olmsted County, Minnesota, 1994-2010. A, Incidence of T1D overall and in those younger than 20 years. Loess-estimated curves depict smoothed trends in incidence (and 95% confidence bands) from the data defined according to granular strata; symbols reflect annual rates summarized across both sexes and the entire age range. B, T1D incidence by age and sex. Symbols represent sex-specific rates summarized by groupings of age: 0-4, 5-9, 10-14, 15-19, 20-29, and 30-39 years (older age groups were omitted because of very low incidence).
Figure 2
Figure 2
Incidence of Type 1 Diabetes and Celiac Disease in Olmsted County, Minnesota, 1994-2010. Loess-estimated curves depict smoothed trends in incidence (and 95% confidence bands) of T1D (solid line) and CD (dashed line); symbols correspond to year-specific incidence rates summarized across both sexes and all ages.
See this image and copyright information in PMC

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