Ambient temperature and sunshine hours are not associated with type 1 diabetes incidence in subtropical Taiwan: a nationwide time-series analysis.

Ya-Hui Chang, Hon-Ping Ma, Hua-Fen Chen, Ping-Ling Chen, I-Lin Hsu, Chung-Yi Li

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Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Ya-Hui ChangSchool of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Emergency Department, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.

Hon-Ping MaGraduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Emergency Department, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Hua-Fen ChenDepartment of Endocrinology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.

Ping-Ling ChenGraduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.

I-Lin HsuDivision of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; The Cross College Elite Program, National Cheng Kung University, Tainan, Taiwan.

Chung-Yi LiDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan. Electronic address: cyli99@mail.ncku.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Seasonal patterns in Type 1 Diabetes (T1D) suggest environmental factors play a role, with colder months linked to higher incidence rates. While low temperatures are a known risk factor, the impact of exposure to shorter sunshine hours is less clear. This study investigated the associations between ambient temperature, sunshine hours, and the incidence of T1D in Taiwan. This cohort study analyzed 3,146 T1D cases aged < 35-years from Taiwan's National Health Insurance data (2015‒2022). The relationships between the weekly number of T1D incident cases, mean daily temperature in a week, and total sunshine hours in a week were evaluated using a distributed lag nonlinear model. When both meteorological factors were considered separately or simultaneously, significantly reduced RRs (0.86‒0.95) of T1D incidence were observed across the temperature range of 17‒19 °C, referenced to 20 °C, but no significant associations with T1D incidence were found for weekly sunshine hours within the observed range of 12-61 h. This study shows that neither lower temperature nor shorter sunshine exposure was significantly associated with increased T1D incidence in Taiwan, potentially due to the region's subtropical climate. Interpretations of the observed reduced risk within the temperature range of 17-19 °C should be made with caution, as this finding may be influenced by residual confounding from seasonally correlated factors, such as viral circulation, behavioral patterns, and indoor environmental conditions.

Indexed as

Ambient temperatureEcological studyIncidenceSubtropical climateSunshine hoursTaiwanTime-series analysisType 1 diabetes

Identifiers

PMID42418934

DOI10.1016/j.clinsp.2026.101050

PMCPMC13356747

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