Rising incidence of childhood type 1 diabetes in Montenegro

Introduction The incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3-4% per annum. Objective The aim of this study was to examine incidence and trends of type 1 diabetes in children aged 0-14 years in Montenegro from 1997 to 2011. Methods This was a prospective study. Primary case ascertainment was from a diabetes register, and a secondary independent data source was from hospital notifications. Case ascertainment was 100% complete using the capture-recapture method. Standardized incidence rates were calculated and trends estimated using the Poisson regression. Results A total of 298 children (157 boys and 141 girls) were diagnosed with type 1 diabetes before 15 years of age during 1997-2011. The mean age-standardized incidence was 15.0/100,000 persons (95% CI: 12.3-17.6) during this period, increasing from 11.7/100,000 in 1997 to 18.8/100,000 in 2011. The age specific rates per 100,000 persons per year were 10.7, 17.2, and 18.2 at ages 0-4 years, 5-9 years, and 10-14 years, respectively. A significant linear trend in incidence (p = 0.002) has been observed over time, with an average annual increase of 4.2%. The increase in incidence was present in both genders, with the largest relative increase in the 0-4 years age group for boys (11.0%; p = 0.006). Conclusion The incidence of type 1 diabetes in Montenegro children continues to increase. We need further monitoring and additional research in order to explain the cause.