The epidemiology of childhood diabetes

There are large differences between countries in the incidence of type 1 diabetes. Europe shows the greatest variation, with the highest incidence in the north-east and lowest in the south-west of the continent. Much of the variation can be explained by genetic differences, but there are notable exceptions and intriguing within-country variations which suggest environmental causes for the disease. One of the most interesting findings is a dramatic increase in diabetes (3–4% per year), predominantly in younger children. The incidence in Finland is now over five times greater than it was 50 years ago. Recently the rise has been most dramatic in countries undergoing substantial socio-economic change, such as those of Eastern Europe. The increase has been attributed to many causes, including diet, enterovirus infection, hygiene, and vitamin D. Epidemiology suggests new approaches for diabetes prevention on a population-wide scale, but further research is still needed to identify factors that can be modified to help reduce diabetes risk and incidence of the disease.