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Exp Clin Endocrinol Diabetes 2012; 120(08): 441-444
DOI: 10.1055/s-0032-1309045
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Incidence of Type 1 Diabetes in Childhood before and after the Reunification of Germany – an Analysis of Epidemiological Data, 1960–2006

S. Ehehalt
1   Paediatric Endocrinology and Diabetes, University Children’s Hospital Tuebingen, Germany
2   Public Health Department of Stuttgart, Department of Pediatrics, Dental Health Care and Social Services, Stuttgart, Germany
,
A. Neu
1   Paediatric Endocrinology and Diabetes, University Children’s Hospital Tuebingen, Germany
,
D. Michaelis
3   Department of Diabetes and Metabolic Diseases, Clinic Karlsburg, Germany
,
P. Heinke
4   Institute of Diabetes Gerhardt Katsch Karlsburg, Karlsburg, Germany
,
A.M. Willasch
5   Hospital for Children and Adolescents, Goethe University, Frankfurt, Germany
,
K. Dietz
6   Department of Medical Biometry, Eberhard-Karls-University, Tuebingen, Germany
,
for the DIARY-Group Baden-Wuerttemberg› Author Affiliations
Further Information

Publication History

received 26 January 2012
first decision 20 March 2012

accepted 21 March 2012

Publication Date:
10 May 2012 (online)

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Abstract

Objective:

To examine the impact of rapidly changing environmental factors on the incidence of type 1 diabetes mellitus (T1D).

Method:

We compared the frequency of T1D in children before and after the reunification of Germany by means of the registries of the German Democratic Republic (GDR, 1960–1989) and of Baden-Wuerttemberg (BW, 1987–2006). The number of cases of diabetes onset in East Germany after the reunification was predicted by a mathematical model. The observed incidence rate in the Eastern part of Germany after the reunification was taken from the literature [1].

Results:

In Germany, the incidence rate of T1D in children aged 0–14 was 7.2/100 000/year (95%-CI 6.9–7.5, GDR, 1980–1987), and 10.4/100 000/year (95%-CI 9.5–11.4, BW, 1987–1994). For the whole observation period (1960–2006), the observed incidence rates y could be described by the square of a linear function [GDR: y=(1.86 + 0.040 * (year – 1960))2; r2=0.85; BW: y=(3.03 + 0.085 * (year – 1987))2, r2=0.89]. The mean rise in incidence before the reunification was less than half the mean rise after the reunification (mean slope: BW 0.085, 95%-CI 0.080–0.090 vs. GDR 0.040, 95% CI 0.036–0.044). The observed incidence for East Germany after 1989 was higher than the prediction on the basis of the GDR ­registry (GDR 12.3/100 000/year vs. Saxony 15.7/100 000/year, 95%-CI 14.2–17.3, n=412; 1999–2003).

Conclusion:

We conclude that the basis for the disease progress is a genetic predisposition. Environmental factors may modify changes in incidence of type 1 diabetes but do not determine the overall risk.

Key words

Type 1 diabetes mellitus - epidemiology - incidence - pathogenesis - environmental factors
*

*  U Bihler, A Böckmann, U Brand, C Döring, R Dürr, D Ecker, F Eickmeier, U Elpel, U Faller, M Fedorcak, L Feldhahn, G Fitzke, P Freisinger, J Grulich-Henn, M Holder, D Jantzen, M Kelle, K Ketteler, M Krüger, B Lippmann-Grob, E Müller, U Radlow, U Rappen, A Ruland, R Sauter, A Schumacher, U Schürmann, KO Schwab, A Veigel, M Wabitsch, J Wissert.