Incidence, prevalence and care of type 1 diabetes in children and adolescents in Germany: Time trends and regional socioeconomic situation

Maike Buchmann; Oktay Tuncer; Marie Auzanneau; Alexander J Eckert; Joachim Rosenbauer; Lukas Reitzle; Christin Heidemann; Reinhard W Holl; Roma Thamm

doi:10.25646/11439

Incidence, prevalence and care of type 1 diabetes in children and adolescents in Germany: Time trends and regional socioeconomic situation

J Health Monit. 2023 Jun 14;8(2):57-78. doi: 10.25646/11439. eCollection 2023 Jun.

Authors

Maike Buchmann¹, Oktay Tuncer¹, Marie Auzanneau^{2

3}, Alexander J Eckert^{2

3}, Joachim Rosenbauer^{4

3}, Lukas Reitzle¹, Christin Heidemann¹, Reinhard W Holl^{2

3}, Roma Thamm¹

Affiliations

¹ Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring.
² Ulm University, Institute for Epidemiology and Medical Biometry, ZIBMT.
³ German Center for Diabetes Research (DZD), München-Neuherberg.
⁴ German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Institute for Biometrics and Epidemiology.

PMID: 37408713
PMCID: PMC10318564
DOI: 10.25646/11439

Abstract

Background: Trends over time and possible socio-spatial inequalities in the incidence and care of type 1 diabetes mellitus (T1D) in children and adolescents are important parameters for the planning of target-specific treatment structures.

Methodology: The incidence and prevalence of type 1 diabetes, diabetic ketoacidosis and severe hypoglycaemia as well as the HbA1c value are presented for under 18-year-olds based on data from the nationwide Diabetes Prospective Follow-up Registry (DPV) and the diabetes registry of North Rhine-Westphalia. Indicators were mapped by sex over time between 2014 and 2020, and stratified by sex, age and regional socioeconomic deprivation for 2020.

Results: In 2020, the incidence was 29.2 per 100,000 person-years and the prevalence was 235.5 per 100,000 persons, with the figures being higher in boys than in girls in either case. The median HbA1c value was 7.5%. Ketoacidosis manifested in 3.4% of treated children and adolescents, significantly more often in regions with very high (4.5%) deprivation than in regions with very low deprivation (2.4%). The proportion of severe hypoglycaemia cases was 3.0%. Between 2014 and 2020, the incidence, prevalence and HbA1c levels changed little, while the proportions of ketoacidosis and severe hypoglycaemia decreased.

Conclusions: The decrease in acute complications indicates that type 1 diabetes care has improved. Similar to previous studies, the results suggest an inequality in care by regional socioeconomic situation.

Keywords: CARE; COMPLICATIONS; DIABETES SURVEILLANCE; HEALTH MONITORING; TYPE 1 DIABETES.

Grants and funding

Parts of the results presented here were funded by the Federal Ministry of Health as a cooperation project in the scope of the establishment of a National Diabetes Surveillance at the Robert Koch Institute (grant codes: GE20150323, GE20190305, 2522DIA700). Further funding was provided by the German Centre for Diabetes Research (grant codes: 82DZD014E03, 82DZD00202) and the German Diabetes Society.