The changing incidence of childhood-onset type 1 diabetes in Wales: Effect of gender and season at diagnosis and birth

      Highlights

      • The incidence of childhood-onset type 1 diabetes in Wales has peaked.
      • Case numbers vary with season suggesting an influence of vitamin D.
      • Increasing hours of sunlight since 1980 may be contributing.

      Abstract

      Aims

      Determinants of the changing incidence of childhood-onset type 1 diabetes remain uncertain. We determined the recent time-trend of type 1 diabetes incidence in Wales and explored the role of vitamin D by evaluating the influence of season both at diagnosis and at birth.

      Methods

      Data from all Welsh paediatric units 1990–2019, and from primary care to determine ascertainment.

      Results

      Log-linear modelling indicated a non-linear secular trend in incidence with peak and subsequent decline. The peak occurred around June 2010: 31∙3 cases/year/100,000 children aged < 15y. It occurred earlier in children younger at diagnosis and earlier in boys. There were more cases in males aged <2y and >12y but more in females aged 9–10 y. More were diagnosed in winter. Also, children born in winter had less risk of future diabetes.

      Conclusions

      The risk of developing type 1 diabetes before age 15y in Wales is no longer increasing. The data on season are consistent with a preventative role for vitamin D both during pregnancy and later childhood. Metereological Office data shows increasing hours of sunlight since 1980 likely to increase vitamin D levels with less diabetes. Additional dietary supplementation with vitamin D might further reduce the incidence of type 1 diabetes.

      Keywords

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