Evidence map›Paper›PMID 30483858›Full record

ArticleDiabetologia2019

Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989-2013: a multicentre prospective registration study.

Christopher C Patterson, Valma Harjutsalo, Joachim Rosenbauer, Andreas Neu, Ondrej Cinek, Torild Skrivarhaug, Birgit Rami-Merhar, Gyula Soltesz, Jannet Svensson, Roger C Parslow and 17 more

Registry-linked trialAbstract read
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In one paragraph

Article in Diabetologia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06427421 (Characterization of Autoreactive Regulatory and Conventional CD4 T Cells in Recent Onset Type 1 Diabetes and Control Individuals), which is not on this map. Cited by 249 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
249citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06427421 narecruitingnot on this mapstarted 2025, after this paper: background citation

Characterization of Autoreactive Regulatory and Conventional CD4 T Cells in Recent Onset Type 1 Diabetes and Control Individuals

TypeinterventionalSponsorAssistance Publique - Hôpitaux de ParisRan2025 to 2027Enrolled80ConditionsType 1 DiabetesArmsFrequency of Treg and Teffs, Phenotype of Treg and Teffs, RNA seq analysis, HLA typing, beta-cell autoantibody dosage
3 · Its place in the literature

Who cites it

249 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  16. Twenty-five years of pediatric type 1 diabetes in Serbia: Trends in age at diagnosis, seasonal variation, and the proportion of diabetic ketoacidosis before, during, and after the COVID-19 pandemic.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2026
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189 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors.

Christopher C PattersonCentre for Public Health and UKCRC Centre of Excellence for Public Health Northern Ireland, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, UK. c.patterson@qub.ac.uk.
Valma HarjutsaloFolkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Joachim RosenbauerGerman Diabetes Center, Institute of Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Andreas NeuUniversity Children's Hospital, Tübingen, Germany.
Ondrej CinekDepartment of Pediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia.
Torild SkrivarhaugDivision of Adolescent and Paediatric Medicine, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, Oslo, Norway.
Birgit Rami-MerharDepartment of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Gyula SolteszDepartment of Paediatrics, Medical School, University of Pécs, Pécs, Hungary.
Jannet SvenssonDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Gentofte, Denmark.
Roger C ParslowLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Conxa CastellDepartment of Health, Government of Catalonia, Barcelona, Spain.
Eugen J SchoenleDepartment of Endocrinology and Diabetology, University Children's Hospital, Zurich, Switzerland.
Polly J BingleyDiabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK.
Gisela DahlquistDepartment of Clinical Sciences, Paediatrics, University of Umeå, Umeå, Sweden.
Przemysława K Jarosz-ChobotDepartment of Children's Diabetology, Medical University of Silesia, Katowice, Poland.
Dalė MarčiulionytėInstitute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Edna F RocheDepartment of Paediatrics, Tallaght University Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland.
Ulrike RotheHealth Sciences/Public Health, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Natasa BratinaDiabetes and Metabolic Diseases, University Children's Hospital, Department of Endocrinology, Ljubljana, Slovenia.
Constantin Ionescu-TirgovisteNational Institute of Diabetes Nutrition and Metabolic Diseases, NC Paulescu, Bucharest, Romania.
Ilse WeetsDiabetes Research Center and Laboratory of Clinical Biology, Brussels Free University-Vrije Universiteit Brussel, University Hospital Brussels-Universitair Ziekenhuis Brussel, Brussels, Belgium.
Mirjana KocovaDepartment of Endocrinology and Genetics, University Children's Hospital, Skopje, Republic of Macedonia.
Valentino CherubiniDivision of Paediatric Diabetes, Azienda University Hospital, Ancona, Italy.
Natasa Rojnic PutarekDepartment of Pediatric Endocrinology and Diabetes, University Hospital Zagreb, Zagreb, Croatia.
Carine E deBeaufortDepartment of Paediatric Diabetes and Endocrinology, University of Luxembourg, Luxembourg, Luxembourg.
Mira SamardzicDepartment of Endocrinology, Institute for Sick Children, Podgorica, Montenegro.
Anders GreenOdense Patient data Exploratory Network (OPEN), Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Funding

Department of Health
6 · The paper itself

Abstract

aims/hypothesisAgainst a background of a near-universally increasing incidence of childhood type 1 diabetes, recent reports from some countries suggest a slowing in this increase. Occasional reports also describe cyclical variations in incidence, with periodicities of between 4 and 6 years.

methodsAge/sex-standardised incidence rates for the 0- to 14-year-old age group are reported for 26 European centres (representing 22 countries) that have registered newly diagnosed individuals in geographically defined regions for up to 25 years during the period 1989-2013. Poisson regression was used to estimate rates of increase and test for cyclical patterns. Joinpoint regression software was used to fit segmented log-linear relationships to incidence trends.

resultsSignificant increases in incidence were noted in all but two small centres, with a maximum rate of increase of 6.6% per annum in a Polish centre. Several centres in high-incidence countries showed reducing rates of increase in more recent years. Despite this, a pooled analysis across all centres revealed a 3.4% (95% CI 2.8%, 3.9%) per annum increase in incidence rate, although there was some suggestion of a reduced rate of increase in the 2004-2008 period. Rates of increase were similar in boys and girls in the 0- to 4-year-old age group (3.7% and 3.7% per annum, respectively) and in the 5- to 9-year-old age group (3.4% and 3.7% per annum, respectively), but were higher in boys than girls in the 10- to 14-year-old age group (3.3% and 2.6% per annum, respectively). Significant 4 year periodicity was detected in four centres, with three centres showing that the most recent peak in fitted rates occurred in 2012. CONCLUSIONS/

interpretationDespite reductions in the rate of increase in some high-risk countries, the pooled estimate across centres continues to show a 3.4% increase per annum in incidence rate, suggesting a doubling in incidence rate within approximately 20 years in Europe. Although four centres showed support for a cyclical pattern of incidence with a 4 year periodicity, no plausible explanation for this can be given.

Indexed as

AdolescentChildChild, PreschoolDiabetes Mellitus, Type 1EuropeFemaleHumansIncidenceInfantInfant, NewbornMaleProspective StudiesRegistriesCyclical variationEpidemiologyIncidenceTemporal changeType 1 diabetes mellitus

Identifiers

PMID30483858

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.