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Type 1 diabetes is a chronic disease, with great variation in incidence rate globally. We have the highest incidence in Finland, with more than 60 new cases per 100,000 children under the age of 15 years and, if we look at the lowest incidence in Europe, this is less than 10 new cases per 100,000 children under the age of 15 years [in Bulgaria and Turkey]. And if we then look at a different continent and ethnic background, in China, for example, the incidence is about one hundredth of that in Finland – so about 0.6 new cases per 100,000 children. What we also know is that the incidence has increased quite dramatically since World War Two in countries where we have available data. So, for example, in my country the incidence has increased more than five-fold over a period of about 55 years. And that tells us that such an increase cannot be due to genes. It must be due to changes in the environment and lifestyle. It may, of course, be a consequence of interactions between changes in environment and genetic factors. If we look at textbooks, they say that you have an incidence peak in pubertal children. As a matter of fact, that is no longer true in high incidence countries, such as Finland. Actually, the incidence is quite evenly spread with age, starting from the age of two years. If diabetes is diagnosed before the age of six months, that is in most cases a monogenic form of diabetes and not type 1 diabetes.
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International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels, Belgium: 2019.
http://www.diabetesatlas.org

Harjutsalo V, Sund R, Knip M, Groop PH. Incidence of type 1 diabetes in Finland. JAMA. 2013 Jul 24;310(4):427-8.
http://jamanetwork.com/journals/jama/article-abstract/1719725

Finnish Pediatric Diabetes Register. (Accessed December 2019.)
http://www.helsinki.fi/en/researchgroups/pediatric-diabetes-research-group/research-projects#section-29481