Systematic Reviews
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 15, 2019; 10(12): 560-580
Published online Dec 15, 2019. doi: 10.4239/wjd.v10.i12.560
Correlating the global increase in type 1 diabetes incidence across age groups with national economic prosperity: A systematic review
Natalia Gomez-Lopera, Nicolas Pineda-Trujillo, Paula Andrea Diaz-Valencia
Natalia Gomez-Lopera, Nicolas Pineda-Trujillo, Grupo Mapeo Genetico, Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín 050010470, Colombia
Paula Andrea Diaz-Valencia, Epidemiology Group. School of Public Health. Universidad de Antioquia, Medellín 050010470, Colombia
Author contributions: Gomez-Lopera N and Diaz-Valencia PA conducted the data collection and analyses; Gomez-Lopera N, Diaz-Valencia PA and Pineda-Trujillo N contributed to the writing of the manuscript. All authors read and approved the final manuscript.
Supported by doctoral scholarship (Natalia Gomez-Lopera) from Colciencias, No. 727.
Conflict-of-interest statement: The authors declare no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Natalia Gomez-Lopera, BSc, PhD, Academic Research, Research Scientist, Pediatrics, Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Carrera 51D No. 62-21, Medellín 050010470, Colombia. natalia.gomezl@udea.edu.co
Telephone: +57-4-2106065 Fax: +57-4-2196069
Received: March 8, 2019
Peer-review started: March 11, 2019
First decision: March 10, 2019
Revised: October 17, 2019
Accepted: October 27, 2019
Article in press: October 27, 2019
Published online: December 15, 2019
Processing time: 284 Days and 2.2 Hours
Abstract
BACKGROUND

The global epidemiology of type 1 diabetes (T1D) is not yet well known, as no precise data are available from many countries. T1D is, however, characterized by an important variation in incidences among countries and a dramatic increase of these incidences during the last decades, predominantly in younger children. In the United States and Europe, the increase has been associated with the gross domestic product (GDP) per capita. In our previous systematic review, geographical variation of incidence was correlated with socio-economic factors.

AIM

To investigate variation in the incidence of T1D in age categories and search to what extent these variations correlated with the GDP per capita.

METHODS

A systematic review was performed to retrieve information about the global incidence of T1D among those younger than 14 years of age. The study was carried out according to the PRISMA recommendations. For the analysis, the incidence was organized in the periods: 1975-1999 and 2000-2017. We searched the incidence of T1D in the age-groups 0-4, 5-9 and 10-14. We compared the incidences in countries for which information was available for the two periods. We obtained the GDP from the World Bank. We analysed the relationship between the incidence of T1D with the GDP in countries reporting data at the national level.

RESULTS

We retrieved information for 84 out of 194 countries around the world. We found a wide geographic variation in the incidence of T1D and a worldwide increase during the two periods. The largest contribution to this increase was observed in the youngest group of children with T1D, with a relative increase of almost double when comparing the two periods (P value = 2.5 × e-5). Twenty-six countries had information on the incidence of T1D at the national level for the two periods. There was a positive correlation between GDP and the incidence of T1D in both periods (Spearman correlation = 0.52 from 1975-1999 and Spearman correlation = 0.53 from 2000-2017).

CONCLUSION

The incidence increase was higher in the youngest group (0-4 years of age), and the highest incidences of T1D were found in wealthier countries.

Keywords: Type 1 diabetes; Incidence; Children; Age categories; Gross domestic product per capita

Core tip: Currently, there is information on the incidence of T1D of 43.3% of the 194 countries of the world, of which only 44 countries have national coverage information. We found a wide geographic variation in the incidence of T1D and a worldwide increase in the two periods (1975-1999 and 2000-2017). Comparing the two periods, the relative increase in the incidence occurred in the 0-4 group (1.9 times), followed by the 5-9 group (1.8 times) and 10-14 group (1.4 times). There was a positive correlation between GDP per capita, and the incidence of T1D, where wealthier countries have higher values of incidence.