Childhood Diabetes in China: Enormous variation by place and ethnic group

Abstract

OBJECTIVE To investigate the incidence rate of IDDM in China. RESEARCH DESIGN AND METHODS The Chinese IDDM registry was established in 1991 as part of the World Health Organization's Multinational Project for Childhood Diabetes (DiaMond) project. Twenty-two centers were developed to monitor the incidence of IDDM in children <15 years of age. The population under investigation includes >20 million individuals, representing ∼7% of the children in China. Capture-recapture methods were used to estimate the ascertainment. RESULTS The overall ascertainment-corrected IDDM incidence rate in China was 0.51 per 100,000, the lowest rate ever reported. There was a 12-fold geographic variation (0.13–1.61 per 100,000). In general, the incidence rate was higher in the north and the east. There was a sixfold difference among ethnic groups (highest: Mongol group, 1.82 per 100,000; lowest: Zhuang group, 0.32 per 100,000). CONCLUSIONS China has an extremely low overall IDDM incidence rate. China also has the greatest geographic and ethnic variation seen for any country.