Aim To determine regional differences in the incidence, incidence
trends, and clinical presentation of type 1 diabetes
in children under the age of 15 years in Croatia in a 9-year
period (1995-2003).
Methods We included the patients who had been diagnosed
with the disease and had started the insulin treatment
before they were 15 years old. Regional differences
between eastern, central, and southern Croatia were observed.
The gross incidence was expressed by the number
of newly diagnosed type 1 diabetes patients in 100 000
children of the same age and sex per year, ie, for the 0-14
age group, and for the 0-4, 5-9, and 10-14 subgroups.
Results The highest incidence was observed in southern
Croatia (10.91 per 100 000/y) and the lowest in central
Croatia (8.64 per 100 000/y), and in eastern Croatia the incidence
was 8.93 per 100 000/y. All three regions showed
a growing incidence trend, which was significant only in
eastern and southern Croatia. There was 35.9% of patients
with diabetic ketoacidosis in eastern Croatia, 41.7% in central
Croatia, and 31.3% in southern Croatia.
Conclusion Croatian regions show differences in the incidence,
incidence trends, and disease presentation of
type 1 diabetes. A further follow-up is needed to establish
whether the regional differences are a consequence of the
population dynamics in the observed period or they will
continue to exist, pointing to differences in environmental
risk factors.