Epidemiology of childhood Type 1 diabetes in Taiwan, 2003 to 2008

Aims: To report the annual incidence rate and the socio-demographic and clinical characteristics of childhood Type 1 diabetes in Taiwan in the period 2003-2008. Methods: A total of 1306 incident cases of childhood (0-14 years) Type 1 diabetes were identified from Taiwan's National Health Insurance claim datasets from the period 2003-2008. The temporal trend of the incidence rate of Type 1 diabetes and the features of hospitalizations in the first year after diagnosis were investigated. The associations of patient characteristics, child population density and the urbanization level of the residential areas with the risk of Type 1 diabetes were assessed using Poisson regression analysis. Results: The annual incidence rate was stable, irrespective of age and gender, with a mean annual incidence rate of 5.3 per 100 000 children. Girls were more likely than boys to develop Type 1 diabetes (6.0 vs 4.7 per 100 000 children) and the incidence rate increased with age. There was no apparent geographic variation in the incidence rates. Despite the 60% decrease in the rate of admission (from 11.0 to 5.8%) over the study period, ketoacidosis remained the major diabetes complication leading to admission for childhood Type 1 diabetes. The multivariate analysis suggested that female gender and older age were significant predictors of the incidence of Type 1 diabetes, whereas the population density of children and the urbanization levels of the residential areas were not. Conclusions: Girls and older children should receive particular attention when formulating preventive strategies targeting Type 1 diabetes. Additionally, clinicians should still carefully optimize the management of children with Type 1 diabetes to further reduce the occurrence of ketoacidosis. What's new?: The incidence of childhood (<15 years) Type 1 diabetes was stable between 2003 and 2008 in Taiwan, with a mean annual incidence rate of 5.3 per 100 000 children. Female gender and older age were significant predictors for the incidence of Type 1 diabetes. Although the rate of admission for Type 1 diabetes decreased by 60% over the study period, ketoacidosis still accounted for 24.6% of all admissions of Type 1 diabetes in 2007-2008 and remained the major complication of diabetes leading to admission in the first year after the onset of Type 1 diabetes.