Global epidemiology of type 1 diabetes in young adults and adults: a systematic review
Open accessAbstract
BACKGROUND: Although type 1 diabetes (T1D) can affect patients of all ages, most epidemiological studies of T1D focus on disease forms with clinical diagnosis during childhood and adolescence. Clinically, adult T1D is difficult to discriminate from certain forms of Type 2 Diabetes (T2D) and from Latent Autoimmune Diabetes in Adults (LADA). METHODS: A systematic review of the literature was performed to retrieve original papers in English, French and Spanish published up to November 6, 2014, reporting the incidence of T1D among individuals aged over 15 years. The study was carried out according to the PRISMA recommendations. RESULTS: We retrieved information reporting incidence of T1D among individuals aged more than 15 years in 35 countries, and published in 70 articles between 1982 and 2014. Specific anti-beta-cell proteins or C-peptide detection were performed in 14 of 70 articles (20%). The most frequent diagnostic criteria used were clinical symptoms and immediate insulin therapy. Country-to-country variations of incidence in those aged >15 years paralleled those of children in all age groups. T1D incidence was larger in males than in females in 44 of the 54 (81%) studies reporting incidence by sex in people >15 years of age. The overall mean male-to-female ratio in the review was 1.47 (95% CI = 1.33-1.60, SD = 0.49, n = 54, p = <0.0001). Overall, T1D incidence decreased in adulthood, after the age of 14 years. CONCLUSIONS: Few studies on epidemiology of T1D in adults are available worldwide, as compared to those reporting on children with T1D. The geographical variations of T1D incidence in adults parallel those reported in children. As opposed to what is known in children, the incidence is generally larger in males than in females. There is an unmet need to evaluate the incidence of autoimmune T1D in adults, using specific autoantibody detection, and to better analyze epidemiological specificities - if any - of adult T1D. PROSPERO REGISTRATION NUMBER: CRD42012002369.
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Geographical variation in type 1 diabetes mellitus incidence in adults mirrors that of children: regions with increased incidence in children are the same as those with increased incidence in adults.
“It is thought that the geographical variation in incidence of T1DM in adults mirrors that of children: regions with increased incidence in children are the same as those with increased incidence in adults17.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [17]
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Spaggiari, M., Bella, C. D., Cocco, P. D., Campara, M., Galen, K., Gheza, F., Oberholzer, J., Benedetti, E., & Tzvetanov, I. G. (2018) · Transplantation · doi:10.1097/tp.0000000000002208 · Cited by 15 · see citing works
Nielsen, N. M., Gørtz, S., Hjalgrim, H., Rostgaard, K., Munger, K. L., Ascherio, A., Magyari, M., Stenager, E., & Frisch, M. (2020) · Multiple Sclerosis Journal · doi:10.1177/1352458520977120 · Cited by 14 · see citing works
Gajewska, K. A., Biesma, R., Sreenan, S., & Bennett, K. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-032916 · Cited by 15 · see citing works
- Authors
- Diaz-Valencia, P. A., Bougnères, P., & Valleron, A.-J.
- Affiliations
- Inserm (FR)
- Venue
- BMC Public Health
- Published
- 2015-03-17
- Volume
- 15
- Issue
- 1
- Pages
- 255-255
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC4381393
- OpenAlex
- W2092063782
- Cited by
- 294
- References
- 91
- Citations by year
- 2026: 15 · 2025: 22 · 2024: 24 · 2023: 34 · 2022: 37 · 2021: 38 · 2020: 38 · 2019: 19 · 2018: 30 · 2017: 18 · 2016: 13 · 2015: 4 · 2014: 2
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by)
- Funders
- Departamento Administrativo de Ciencia, Tecnología e Innovación (COLCIENCIAS)
- Centre National de la Recherche Scientifique
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 1 diabetes, adult-onset type 1 diabetes, incidence, young adults, sex differences, regional variation, autoantibodies, C-peptide, latent autoimmune diabetes in adults, type 2 diabetes misdiagnosis, autoimmune disease
- MeSH terms
- Adolescent, Adult, Child, Diabetes Mellitus, Type 1, Female, Humans, Male, Middle Aged, Global Health, Incidence, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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