Increased Risk of Cancer Mortality Associated With Time-Varying Exposure to Exogenous Insulin Therapy in Type 2 Diabetes.

Abstract

Increasing Incidence and Prevalence of Diabetes between 1995 and 2006 in Young Children and Adolescents in Alberta, Canada. JEFFREY A. JOHNSON, STEPHANIE U. VERMEULEN, ROBERT M. COUCH,SETH D. MARKS, DANIELE PACAUD, GREG HUGEL. School of Public Health, University of Alberta, Edmonton, AB. Institute of Health Economics, Edmonton, AB, Department of Pediatrics, University of Alberta, Edmonton, AB. Diabetes is largely a disease of older adults, but increasing incidence has been reported for children and adolescents in many countries. We analyzed epidemiologic trends of diabetes in children and adolescents over the past decade in the province of Alberta. Administrative databases from Alberta Health and Wellness were used to identify cases of diabetes among Albertans aged 1 to 19 years. The Canadian National Diabetes Surveillance System (NDSS) algorithm was used to identify cases. Annual incidence and prevalence rates were compared across time (1995-2006) using multivariable logistic regression, adjusting for age, sex and First Nations status. Among 2301 prevalent cases of diabetes in the Alberta population under 20 years of age in 2006, 49% were female and 5.5% were First Nations. Nearly one-half (45%) of prevalent cases were 15-19 years old; 33% were 10-14 years, 16% were 5-9 years and 6% were 1-4 years. Prevalence increased 47%, from 18.7 per 10,000 in 1995 to 27.5 per 10,000 in 2006. Prevalence increased 94% for 1-4 years, 51% for 5-9 years, 43% for 10-14 years and 29% for 15-19 years (p=0.005). The annual incidence rate increased from 2.2 per 10,000 in 1995 to 3.1 per 10,000 in 2006. Incidence rates increased 68% for 1-4 years, 68% for 5-9 years, 43% for 10-14 years, and 3.0% for 1519 years (p=0.034). Prevalence was 23% (95%CI: 15-31%; p<0.001) higher for First Nations, although incidence rates were not different (p=0.314), compared to non-First Nations. Over the last decade, diabetes rates have increased significantly in all pediatric age groups in Alberta. The largest increases occurred in the younger age groups, who are most likely to have type 1 diabetes. ABSTRACT #39