Long-term patterns in seasonality of insulin-dependent diabetes mellitus diagnosis in Austrian children

doi:10.1016/S0895-4356(96)00334-4

Journal of Clinical Epidemiology

Volume 50, Issue 2, February 1997, Pages 159-165

https://doi.org/10.1016/S0895-4356(96)00334-4 Get rights and content

Abstract

The analysis of the seasonal pattern of incidence of childhood insulin-dependent diabetes mellitus in Austria was carried out among cases where the child was under the age of 15 when diagnosed between 1979 and 1993. The cases are registered in the nationwide population-based Austrian insulin-dependent diabetes mellitus registry. Seasonal variation was compared between boys and girls and between three 5-year age groups. We also tested whether the seasonal pattern changed over the 15-year observation period.

We found a significant seasonal variation among boys aged 10–14 and girls aged 5–14, while in the 0–4 years age group no seasonal pattern could be demonstrated. Two peaks in incidence were identified during a calendar year (February–March and September–October) for girls aged 5–14. For boys aged 10–14, a yearly cycle was found with a peak in January and October. An extension of the Poisson regression model for testing seasonality by Jones et al. was developed to allow for estimation of a time-dependent amplitude of the seasonal component.

The annual incidence rate increased by 36% during the observation period, but no significant change in seasonal pattern could be demonstrated.

References (26)

A Green et al.
Incidence of childhood-onset insulin-dependent diabetes mellitus: The Eurodiab Ace study
Lancet
(1992)
L Nystrom et al.
The Swedish childhood diabetes study—an analysis of the temporal variation in diabetes incidence 1978–1987
Int J Epidemiol
(1990)
J Tuomilehto et al.
Increasing trend in type 1 (insulin-dependent) diabetes mellitus in childhood in Finland: Analysis of age; calendar time and birth cohort effects during 1965–1984
Diabetologia
(1991)
A Green et al.
Increasing incidence of early onset type 1 (insulin-dependent) diabetes mellitus: A study of Danish male birth cohorts
Diabetologia
(1992)
CEM Drykomingen et al.
The incidence of male childhood type 1 (insulin-dependent) diabetes is rising rapidly in The Netherlands
Diabetologia
(1992)
G Soltesz et al.
Rising incidence of type 1 diabetes in Hungarian children 1978–1987
Diabetic Med
(1989)
E Schober et al.
Increasing Incidence of IDDM in Austrian Children—A nationwide study
Diabetes Care
(1995)
N Tajima et al.
Incidence of insulin-dependent diabetes mellitus outside Europe
RH Jones et al.
Seasonality comparisons among groups using incidence data
Biometrics
(1988)
E Schober et al.
Incidence of childhood diabetes mellitus in Austria, 1979–1984
Acta Paed Scand
(1988)

E Schober

Studiengruppe zur Inzidenz des kindlichen Diabetes mellitus in Österreich—Ergebnisse einer prospektven Studie 1989–1990

Päd Paedol

(1992)

Gauss Applications, Aptech Systems, Inc., 23804 S.E. Kent-Kangley Road, Maple Valley, WA 98038...

PJ Bingley et al.

Incidence of insulin-dependent diabetes in England: A study in the Oxford region 1985–1986

Br Med J

(1989)

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Original articleLong-term patterns in seasonality of insulin-dependent diabetes mellitus diagnosis in Austrian children

Abstract

Lancet

The Swedish childhood diabetes study—an analysis of the temporal variation in diabetes incidence 1978–1987

Int J Epidemiol

Increasing trend in type 1 (insulin-dependent) diabetes mellitus in childhood in Finland: Analysis of age; calendar time and birth cohort effects during 1965–1984

Diabetologia

Increasing incidence of early onset type 1 (insulin-dependent) diabetes mellitus: A study of Danish male birth cohorts

Diabetologia

The incidence of male childhood type 1 (insulin-dependent) diabetes is rising rapidly in The Netherlands

Diabetologia

Rising incidence of type 1 diabetes in Hungarian children 1978–1987

Diabetic Med

Increasing Incidence of IDDM in Austrian Children—A nationwide study

Diabetes Care

Incidence of insulin-dependent diabetes mellitus outside Europe

Seasonality comparisons among groups using incidence data

Biometrics

Incidence of childhood diabetes mellitus in Austria, 1979–1984

Acta Paed Scand

Studiengruppe zur Inzidenz des kindlichen Diabetes mellitus in Österreich—Ergebnisse einer prospektven Studie 1989–1990

Päd Paedol

Incidence of insulin-dependent diabetes in England: A study in the Oxford region 1985–1986

Br Med J

Original article
Long-term patterns in seasonality of insulin-dependent diabetes mellitus diagnosis in Austrian children