Changes in the incidence and prevalence of type 1 and type 2 diabetes among 2 million children and adolescents in Hungary between 2001 and 2016 - a nationwide population-based study

László Barkai; Zoltán Kiss; György Rokszin; Zsolt Abonyi-Tóth; György Jermendy; István Wittmann; Péter Kempler

doi:10.5114/aoms.2019.88406

Changes in the incidence and prevalence of type 1 and type 2 diabetes among 2 million children and adolescents in Hungary between 2001 and 2016 - a nationwide population-based study

Arch Med Sci. 2019 Oct 7;16(1):34-41. doi: 10.5114/aoms.2019.88406. eCollection 2020.

Authors

László Barkai^{1

2}, Zoltán Kiss³, György Rokszin⁴, Zsolt Abonyi-Tóth⁵, György Jermendy⁶, István Wittmann³, Péter Kempler⁷

Affiliations

¹ Institute of Theoretical Health Sciences, Faculty of Health Care, University of Miskolc, Miskolc, Hungary.
² Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.
³ 2 Department of Medicine and Nephrological Center, Medical Faculty, University of Pécs, Pécs, Hungary.
⁴ RxTarget Statistical Agency, Szolnok, Hungary.
⁵ University of Veterinary Medicine, Budapest, Hungary.
⁶ Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
⁷ 1 Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary.

Abstract

Introduction: The aim of the present study was to assess changes in the incidence and prevalence of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in children and adolescents in Hungary during the period 2001 to 2016 in order to provide nationwide population-based epidemiology data on diabetes in youths aged 0-18 years.

Material and methods: This was a retrospective cohort study of Hungarian children and adolescents aged 18 years or younger. Pharmacologically treated diabetes cases were obtained through a population-based registry of the Hungarian National Health Insurance Fund. Time series analysis was used to evaluate the changing patterns of the incidence and prevalence for type 1 and type 2 diabetes covering a 16-year period.

Results: During the study period, 6,138 and 1,997 new T1DM and T2DM cases were observed, respectively. Newly diagnosed T2DM cases accounted for 24.5% of all incident diabetes cases. Incidence of T1DM increased from 16/100,000 to 23/100,000 (R ² = 0.7681; p < 0.0001). The male-to-female ratio among newly diagnosed T1DM patients did not change over the study period. Prevalence of T1DM rose from 114/100,000 to 209/100,000 (R ² = 0.9909; p < 0.0001). The prevalent T1DM cases showed significant male predominance in every year (p < 0.05). Incidence of T2DM decreased from 8/100,000 to 5/100,000 (R ² = 0.4977; p < 0.0014). The overall prevalence of T2DM did not change significantly. Prevalent T2DM cases showed significant female predominance in every year (p < 0.0001). A significant decrease in male-to female ratio was observed among newly diagnosed T2DM cases over the study period (p < 0.0001).

Conclusions: According to these population-based Hungarian data of children and adolescents with diabetes, T1DM is still the most common form and its frequency continues to rise, affecting more males than females. A high proportion of patients have T2DM, affecting more females than males, but the occurrence of medically treated cases is not increasing. The decrease in male-to-female ratio in newly diagnosed T2DM cases needs further investigations.

Keywords: adolescents; children; incidence; prevalence; type 1 diabetes; type 2 diabetes.