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Prevalence and incidence of type 1 diabetes in Ireland: a retrospective cross-sectional study using a national pharmacy claims data from 2016

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Gajewska, Katarzyna Anna, Biesma, Regien, Sreenan, Seamus, Bennett, Kathleen·2020·BMJ Open
DOI 10.1136/bmjopen-2019-032916PMC PMC7245400
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Abstract

Objectives: The aim of this study is to estimate the prevalence and incidence of type 1 diabetes in the Irish population using a national pharmacy claims database in the absence of a national diabetes register. Design: National, population-based, retrospective, cross-sectional study. Setting: Community care with data available through the Health Service Executive Pharmacy Claims Reimbursement Scheme from 2011 to 2016. Participants: Individuals with type 1 diabetes were identified by coprescription of insulin and glucometer test strips without any prolonged course (>12 months) of oral hypoglycaemic agents prior to commencing insulin. Those claiming prescriptions for long-acting insulin only, without any prandial insulin, were excluded from the analysis. Incidence was estimated based on the first claim for insulin in 2016, with no insulin use in the preceding 12 months. Main outcome measures: Prevalence of type 1 diabetes in children (<18 years) and adults (≥18 years); incidence of type 1 diabetes in children (≤14 years) and adolescents and adults (>14 years). Results: There were 20 081 prevalent cases of type 1 diabetes in 2016. The crude prevalence was 0.42% (95% CI 0.42% to 0.43%). Most prevalent cases (n=17 053, 85%) were in adults with a prevalence of 0.48% (95% CI 0.47% to 0.48%). There were 1527 new cases of type 1 diabetes in 2016, giving an incidence rate of 32 per 100 000 population/year (95% CI 30.5 to 33.7). There was a significant positive linear trend for age, for prevalence (p<0.0001) and incidence (p=0.014). The prevalence and incidence were 1.2-fold and 1.3-fold higher in men than women, respectively. Significant variations in prevalence (p<0.0001) and incidence (p<0.001) between the different geographical regions were observed. Conclusions: This study provides epidemiological estimates of type 1 diabetes across age groups in Ireland, with the majority of prevalent cases in adults. Establishing a national diabetes register is essential to enable updated epidemiological estimates of diabetes and for planning of services in Ireland.

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  • Several studies report an incidence peak of type 1 diabetes mellitus in older adults of a similar size to or exceeding that in children.

    “Several studies report an incidence peak of T1DM in older adults of a similar size to or exceeding that in children”

    From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [13]

    The Results (Incidence; page not provided) identify people aged 75 and over and children aged 14 and under among the groups with the highest incidence. But this paper provides only one older-adult incidence finding: the Italian study discussed has no data for older age groups. The Discussion also cautions that double-counting may help explain its high incidence estimate for older adults, so it does not establish that several studies report such a peak. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • In Ireland, type 1 diabetes mellitus incidence was 54.2 per 100,000 in those aged ≥75 years and 41.2 per 100,000 in those aged 65-74 years, higher than the youth peak of 31.7 per 100,000 in those aged 0-14 years.

    “The authors reported an incidence of 54.2 per 100,000 people (95% CI 45.3–63.0) in those aged ≥75 years and 41.2 per 100,000 people (95% CI 34.7–47.7) in those aged 65–74 years. These estimates were higher than the incidence observed in youth, which peaked at 31.7 (95% CI 28.2–35.2) per 100,000 people in those aged 0–14 years.”

    From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [13]

  • In Ireland, type 1 diabetes mellitus prevalence increased with increasing age, from 0.18% among those aged 0-14 years to 0.74% in those aged ≥75 years.

    “In Ireland, prevalence increased with increasing age, from 0.18% (95% CI 0.18–0.19) among those aged 0–14 years to 0.74% (95% CI 0.71–0.77) in those aged ≥75 years13.”

    From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [13]

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Cited by

Sorted by citations

Authors
Gajewska, K. A., Biesma, R., Sreenan, S., & Bennett, K.
Affiliations
  • Royal College of Surgeons in Ireland (IE)
  • University Medical Center Groningen (NL)
  • 3U Diabetes, Royal College of Surgeons in Ireland, Dublin, Ireland
Corresponding author
Gajewska, Katarzyna Anna
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2020-04
Volume
10
Issue
4
Pages
e032916
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2019-032916
PMC
PMC7245400
OpenAlex
W3016739574
Cited by
15
References
3
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2022: 5 · 2021: 1 · 2020: 2
FWCI
1.51
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by-nc)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Figshare (submittedVersion, cc-by-nc)
  • HighWire Press Open Archive (submittedVersion)
  • Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion, cc-by-nc)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
Funders
Health Research Board (SPHeRE/2013/1)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
type 1 diabetes, prevalence, incidence, pharmacy claims data, insulin prescription, age and sex differences, regional variation, National Diabetes Register, Ireland, children and adolescents, adults, sex differences in incidence, incidence trends, geographic variation in incidence, sex differences in prevalence
MeSH terms
Adolescent, Adult, Aged, Child, Child, Preschool, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemic Agents, Infant, Infant, Newborn, Insulin, Insurance Claim Reporting, Insurance Claim Review, Insurance, Pharmaceutical Services, Ireland, Male, Middle Aged, Reagent Strips, Retrospective Studies, Incidence, Prevalence, Databases, Factual, Age Distribution, Sex Distribution, Young Adult

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