Incidence of IDDM in German children aged 0-14 years - A 6-year population-based study (1987-1993)

OBJECTIVE - Generally accepted data on the incidence of childhood diabetes in Germany have not been available up to now To register the total number of newly diagnosed cases in Baden-Wuerttemberg (a federal state in southwest Germany), data on 1,160 children were retrospectively collected for the years 1987-1993. RESEARCH DESIGN AND METHODS - Hospital records were the primary data source. There were 32 hospital units in Baden-Wuerttemberg included in this study. A secondary independent data source was a questionnaire circulated among the patients' association, Deutscher Diabetiker Bund. Case definition was done according to criteria EURODIAB ACE, a collaborative European study set up to assess the incidence of childhood diabetes. The degree of ascertainment was 96.2%, using the capture-mark-recapture method. The study includes a population at risk, entailing 1.5 million children, corresponding to 12.3% of all German children. RESULTS - The incidence was found to be 11.6/100,000 (95% CI 10.9-12.2) for children aged 0-14 years. There was no significant difference between the incidence rates of boys and girls. Seasonal variation was observed, with cases increasing between November and February and incidence increasing with age. Peaks were found in early childhood (3-4 years of age) and prepuberty (10-12 years of age). There was marked geographical variation that did not correlate significantly with population density. CONCLUSIONS - For the first time, internationally comparable data on the incidence of diabetes in children up to 15 years of age are available for Germany. The yearly incidence of 11.6/100,000 proved to be much higher than assumed so far.