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. 2019 Sep:37:37-42.
doi: 10.1016/j.annepidem.2019.07.006. Epub 2019 Jul 12.

Estimating prevalence of type I and type II diabetes using incidence rates: the SEARCH for diabetes in youth study

Thaddäus Tönnies  1 , Giuseppina Imperatore  2 , Annika Hoyer  3 , Sharon H Saydah  2 , Ralph B D'Agostino Jr  4 , Jasmin Divers  4 , Scott Isom  4 , Dana Dabelea  5 , Jean M Lawrence  6 , Elizabeth J Mayer-Davis  7 , Catherine Pihoker  8 , Lawrence Dolan  9 , Ralph Brinks  3
Affiliations

Estimating prevalence of type I and type II diabetes using incidence rates: the SEARCH for diabetes in youth study

Thaddäus Tönnies et al. Ann Epidemiol. 2019 Sep.

Abstract

Purpose: Most surveillance efforts in childhood diabetes have focused on incidence, whereas prevalence is rarely reported. This study aimed to assess whether a mathematical illness-death model accurately estimated future prevalence from baseline prevalence and incidence rates in children.

Methods: SEARCH for Diabetes in Youth is an ongoing population-based surveillance study of prevalence and incidence of diabetes and its complications among youth in the United States. We used age-, sex-, and race/ethnicity-specific SEARCH estimates of the prevalence of type I and type II diabetes in 2001 and incidence from 2002 to 2008. These data were used in a partial differential equation to estimate prevalence in 2009 with 95% bootstrap confidence intervals. Model-based prevalence was compared with the observed prevalence in 2009.

Results: Most confidence intervals for the difference between estimated and observed prevalence included zero, indicating no evidence for a difference between the two methods. The width of confidence intervals indicated high precision for the estimated prevalence when considering all races/ethnicities. In strata with few cases, precision was reduced.

Conclusions: Future prevalence of type I and type II diabetes in youth may be accurately estimated from baseline prevalence and incidence. Diabetes surveillance could benefit from potential cost savings of this method.

Keywords: Adolescents; Children; Epidemiology; Ethnic groups; Illness-death model; Surveillance; Type I diabetes; Type II diabetes.

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Figures

Fig. 1.
Fig. 1.
Illness-death model.
Fig. 2.
Fig. 2.
Prevalence of type I (A) and type II (B) diabetes in U.S. youth aged 0–19 years by age, sex, and race/ethnicity in 2001.
Fig. 3.
Fig. 3.
Observed (solid line) and estimated (dotted line) prevalence of type I diabetes (A) and type II diabetes (B) in U.S. males in 2009 by age and race/ethnicity, shaded area represents 95% confidence intervals.
Fig. 4.
Fig. 4.
Observed (solid line) and estimated (dotted line) prevalence of type I diabetes (A) and type II diabetes (B) in U.S. females in 2009 by age and race/ethnicity, shaded area represents 95% confidence intervals.
Fig. 5.
Fig. 5.
Differences between the observed and estimated prevalence of type I diabetes (A) and type II diabetes (B) in U.S. males in 2009 by age and race/ethnicity, shaded area represents 95% confidence intervals.
Fig. 6.
Fig. 6.
Differences between the observed and estimated prevalence of type I diabetes (A) and type II diabetes (B) in females in 2009 by age and race/ethnicity, shaded area represents 95% confidence intervals.
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