Background

Population-based incidence data on young-adult-onset type 1 diabetes and type 2 diabetes are limited. We aimed to examine secular trends in the incidence of diagnosed type 1 diabetes and type 2 diabetes with an age of onset between 15 and 39 years.

Methods

In this multicountry aggregate data analysis, we assembled eight administrative datasets from high-income jurisdictions and countries (Australia, Denmark, Finland, Hungary, Japan, Scotland, South Korea, and Spain [Catalonia]) that had appropriate data available from an international diabetes consortium (GLOBODIAB) describing incidence by diabetes type among people aged 15–39 years from 2000 to 2020. We modelled type 1 diabetes and type 2 diabetes incidence rates using Poisson regression including age and calendar time by sex.

Findings

During the years 2000–20, there were 349 591 incident diabetes (both types) cases from 346 million person-years of follow-up among people aged 15–39 years. Over time, there was no statistically significant change in the incidence of type 1 diabetes in Hungary and Japan. The incidence of type 1 diabetes significantly increased in Australia, Denmark, Finland, Scotland, South Korea, and Spain, with annual changes ranging from 0·5% to 6·0%. The incidence of type 2 diabetes significantly increased in four of eight jurisdictions (Denmark, Finland, Japan, and South Korea), with annual increases from 2·0% to 8·5%. The magnitude of increase in incidence of type 2 diabetes was greater in Asian than non-Asian jurisdictions. There was no statistically significant change in type 2 diabetes incidence in Australia and Hungary. The incidence of type 2 diabetes significantly decreased in Scotland and Spain, with annual changes of –0·7% and –1·5%, respectively.

Interpretation

There is variability in the trajectory of the incidence of young-adult-onset type 2 diabetes among high-income countries or jurisdictions, with a greater evidence of increase in Asian than non-Asian countries. Evolving trends in the incidence of type 1 and type 2 diabetes in young adults call for the ongoing surveillance of diabetes incidence and a greater research focus on this population.

Funding

US Centers for Disease Control and Prevention, Diabetes Australia Research Programme, and Victoria State Government Operational Infrastructure Support Programme.

中文翻译：

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按糖尿病类型划分的年轻成人糖尿病发病率趋势：来自国际糖尿病联盟的一项基于人群的跨国研究

 背景

关于年轻成人发病的 1 型糖尿病和 2 型糖尿病的人群发病率数据有限。我们旨在检查诊断为 1 型糖尿病和 2 型糖尿病发病年龄在 15 至 39 岁之间的糖尿病发病率的长期趋势。

 方法

在这项多国汇总数据分析中，我们收集了来自高收入司法管辖区和国家（澳大利亚、丹麦、芬兰、匈牙利、日本、苏格兰、韩国和西班牙 [加泰罗尼亚]）的八个行政数据集，这些数据集拥有来自国际糖尿病联盟 （GLOBODIAB） 的适当数据，描述了 2000 年至 2020 年按糖尿病类型划分的 15-39 岁人群的发病率。我们使用泊松回归对 1 型糖尿病和 2 型糖尿病发病率进行建模，包括按性别划分的年龄和日历时间。

 发现

在 2000-20 年期间，在 15-39 岁的人群中，在 3.46 亿人年的随访中，有 349 591 例糖尿病（两种类型）新发病例。随着时间的推移，匈牙利和日本的 1 型糖尿病发病率没有统计学上的显着变化。澳大利亚、丹麦、芬兰、苏格兰、韩国和西班牙的 1 型糖尿病发病率显著增加，年变化从 0·5% 到 6·0% 不等。8 个司法管辖区中的 4 个辖区（丹麦、芬兰、日本和韩国）的 2 型糖尿病发病率显著增加，年增长率从 2·0% 增加到 8·5%。亚洲司法管辖区 2 型糖尿病发病率的增加幅度大于非亚洲司法管辖区。澳大利亚和匈牙利的 2 型糖尿病发病率没有统计学意义的变化。苏格兰和西班牙的 2 型糖尿病发病率显着下降，年变化分别为 -0·7% 和 -1·5%。

 解释

高收入国家或司法管辖区的年轻成人发病 2 型糖尿病发病率轨迹存在差异，亚洲国家比非亚洲国家有更多证据表明发病率增加。年轻人 1 型和 2 型糖尿病发病率的演变趋势要求对糖尿病发病率进行持续监测，并更加关注这一人群。

 资金

美国疾病控制和预防中心、澳大利亚糖尿病研究计划和维多利亚州政府运营基础设施支持计划。