Climates on incidence of childhood type 1 diabetes mellitus in 72 countries

Abstract

We are aimed to systematically assess the worldwide trend in incidence of childhood type 1 diabetes mellitus (CT1DM) from 1965 to 2012 and to discuss whether climate affect incidence of CT1DM. We searched the relevant literatures in detail to judge the effect of different climates on incidence of CT1DM. The climates included Mediterranean, monsoon, oceanic, continental, savanna, and rainforest. According to different climates, we further researched relevant factor such as sunshine durations and latitudes. The overall incidence of CT1DM in 72 countries was 11.43 (95% CI 10.31-12.55) per 100,000 children/yr. The incidence of CT1DM in Oceanic climate [10.56 (8.69-12.42)] is highest compared with other climates; the incidence in 40°-66°34'N/S [14.71 (12.30-17.29)] is higher than other latitude groups; the incidence in sunshine durations with 3-4 hours per day [15.17 (11.14-19.20)] is highest compared with other two groups; the incidence of CT1DM from 2000 to 2012 [19.58 (14.55-24.60)] is higher than other periods; all p < 0.01. Incidence of CT1DM was increasing from 1965 to 2012, but incidence in Oceanic climate is higher than other climates. Furthermore, it is higher in centers with higher latitude and lower sunshine durations. The climates might play a key role in inducing CT1DM.

Figure 1

Incidence of childhood type 1 diabetes mellitus in 72 countries (the first author independently created map by software-Adobe Illustrator CS5 and Adobe Photoshop CS5, and the copyright of map belongs to first author).

Figure 2

Incidence of childhood type 1 diabetes mellitus in different regions, age-groups, climates, and sunshine durations. (A, Incidence of childhood type 1 diabetes mellitus in different regions: ^#indicated North America vs. other regions excluded Oceania, all p < 0.01; B, Incidence of childhood type 1 diabetes mellitus in three age-groups: ^#represented 0–4 years old vs. 10–14 years old, p < 0.01; C, Incidence of childhood type 1 diabetes mellitus in seven kinds of climates: *represented Monsoon climate vs. other climates excluded Savanna climate and Rainforest climate, all p < 0.01; D, Incidence of childhood type 1 diabetes mellitus in three sections of sunshine durations: ^#showed 3–4 hours/day vs. other two sections, both p < 0.01; all p derived from one-way ANOVA).

Figure 3

Incidence of childhood type 1 diabetes mellitus in three latitude sections (*expressed 40°–66°34′N/S vs. other two latitude sections, both p < 0.01, p derived from the one-way ANOVA).

Figure 4

Incidence of childhood type 1 diabetes mellitus among four stages (*revealed 2000 to 2012 vs. other two stages, all p < 0.01, p derived from the one-way ANOVA).