Childhood diabetes cases have risen sharply in Europe over the past 30 years, but some countries are more affected than others, novel study finds

Diabetes is a global health problem. People with the disease produce little or no insulin, or have an ineffective response to insulin, causing their blood sugar levels to become abnormally high.

Among the different types of diabetes, type 1 is most common in children and adolescents – in 2019 about 1.5 million people under the age of 20 affected by the disease worldwide, and of the 16,300 deaths attributed to diabetes in people under 25 years of age, 73.7% of cases were caused by type 1 diabetes.

Despite recent progress, treating this disease still poses a challenge to healthcare systems worldwide.

A huge health problem for children

Type 1 diabetes is chronic autoimmune disease in which the immune system attacks and destroys the cells in the pancreas that produce insulin. To make up for the deficiency, patients must be given insulin via injections or delivery devices such as insulin pumps.

People with diabetes must also monitor their blood sugar levels, as well as their nutrient intake (especially carbohydrates), physical activity, and other factors that can change blood glucose levels.

Impoverished disease management raises blood sugar levels. Over time, this can affect or damage major organs in the body, including the heart, blood vessels, nerves, eyes, and kidneys.

It is therefore crucial to understand changes in the number of teenage people with the disease to determine its causes and provide health workers with data that will aid identify novel cases as early as possible.

The number of cases has almost doubled

To provide much-needed information, the occurrence was investigated – the percentage of novel cases of the disease in a given period of time relative to the population likely to develop it – type 1 diabetes in 32 European countries between 1994 and 2021. To do this, we analysed a total of 75 studies covering 219,331 people aged 0 to 14 years.

We found that the incidence of type 1 diabetes has increased significantly: from 11 cases per 100,000 years-person in 1994–2003 to approximately 21 cases per 100,000 person-years in 2013–2021.

Differences between countries

In addition, we identified significant differences between European regions. While there is a clear upward trend in most European countries – especially in Northern Europe such as Finland, Sweden and Norway – in some figures, including the UK and Spain, they appear to have stabilised.

In 2013–2021, the latest period studied, the lowest incidence rate was recorded in Romania and Turkey (11 and 12 cases per 100,000 person-years, respectively), and the highest in Finland and Ireland (56 and 33 cases).

In Spain, the boost was less steep, with 16 cases per 100,000 person-years reported between 1994 and 2003, increasing only slightly to 17.5 between 2013 and 2022.

Across Europe, boys showed slightly higher numbers than girls. We also observed that incidence rates increased with age, particularly in the 10-14 age group.

What is behind these rising numbers?

The origins of type 1 diabetes are still unknown, although some lines of research indicate that there is a genetic predisposition. Other triggers have also been suggested, including: autoimmune processes, virusesand lifestyle or environmental factors such as diet.

We also observed that higher per capita income or living in a country further north, such as Finland, Sweden or Norway, may affect the incidence of type 1 diabetes.

There are several possible explanations for this phenomenon, including the fact that northern countries receive less ultraviolet radiation (i.e. sunlight) – several studies found that exposure to ultraviolet radiation may protect against diabetes because it slows down the body’s immune response.

The effect of the pandemic

Another noteworthy fact is the boost in the number of novel cases of type 1 diabetes in children worldwide since the COVID-19 pandemic.

This may be due to the impact of infection on the immunity of susceptible people or the confined ability of health systems to detect the problem early and keep it under control.

Further work is now needed on health policies that promote hearty lifestyles and control environmental risk factors that underlie the immune problems associated with this major public health challenge.