Increasing Ten-Year Burden of Pediatric Type 1 Diabetes Mellitus in Southeastern Wisconsin: Relationship with Body Weight at Diagnosis

Purpose Several studies in Europe have documented the increase in incidence of Type 1 Diabetes Mellitus (T1DM) and the apparent relationship with increase weight at diagnosis. Such data suggests that maintaining a healthy weight throughout childhood may delay the onset of T1DM into adolescents. This is the first study conducted in the Midwest examining this issue. Our objective was to determine if there is an increasing burden of T1DM in specific age cohorts and if increasing body weight is an apparent risk factor for this increase. Methods Retrospective chart review of all 1618 newly diagnosed children and adolescents (<19 years) with T1DM January 1995 through December 2004 from an urban academic childrenʹs hospital, Milwaukee, WI, USA representing 86-93% of pediatric inpatient admissions in the region in 1995–2004 and the primary source for newly diagnosed pediatric diabetes care. Results An overall, estimated annual incidence, which increased from 18.8 to 40.3/100,000 (p=0.006) over 10 years was observed, with an average yearly cumulative incidence of 2.39%. The increase in incidence was largest in the younger age groups with children ages 0–4, 5–9, and 10–14 having an average yearly increase of 2.4, 2.3, and 3.0% respectively; corresponding to a relative 10-year increase of 25.2, 32.6, and 37.9%, respectively. Age at diagnosis was inversely correlated with weight z-score (p<0.001) and BMI z-score (p<0.001) and remained significant for both males and females. Conclusion The incidence of T1DM increased 2-fold in Southeastern Wisconsin over 10 years. The majority of the increase was in the youngest age groups, which were comparatively the heaviest. Our observations suggest excess weight gain during childhood may be a risk factor for early manifestation of T1DM.