Trends in the incidence of childhood diabetes in south Asians and other children in Bradford, UK

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Abstract
Aims To investigate incidence rates and time trends, over 21 years, of Type 1 diabetes in a migrant population of south Asian children in Bradford, UK. Methods Children (0–14 years) living in the city of Bradford and diagnosed with Type 1 diabetes were selected from a population‐based region‐wide register. Between 1978 and 1998, 289 new‐onset cases were registered and classified as south Asian (Indian, Pakistani, Bangladeshi) or not, based on their full name using two different computer algorithms and visual inspection. Results Sixty‐six children (22.8%) were designated as south Asian with 223 (77.2%) remaining. The overall age–sex standardized incidence for south Asian and non‐south Asian children was 13.0 per 100 000 person years (95% confidence interval 9.9–16.2) and 12.9 (11.2–14.6), respectively. Rates were similar for south Asians at all ages, whereas for the mainly Caucasian children incidence differed significantly by age group (P < 0.001). An average annual increase in incidence of 4.3% (P = 0.001) was seen for all children compared with 6.5% in south Asians (P = 0.002) and 2.4% (P = 0.128) in non‐south Asians. Conclusions Children in south Asia have a low incidence of Type 1 diabetes but migrants to the UK have similar overall rates to the indigenous population. However, a more steeply rising incidence is seen in the south Asian population, and our data suggest that incidence in this group may eventually outstrip that of the non‐south Asians. Genetic factors are unlikely to explain such a rapid change, implying an influence of environmental factors in disease aetiology. The similarity in rates by age group in the south Asian population is notable.