Type 1 Diabetes Incidence Skyrocketing in China

written by Sarah Howard
Coordinator, Diabetes-Obesity Spectrum Working Group

Sarah HowardYou may have seen the news, published in JAMA, that type 1 diabetes prevalence in US children increased by 21.1% between 2001 and 2009 (Dabelea et al. 2014).

You may not have seen the news from the other side of the world, that type 1 diabetes incidence increased by 14.2% per year in Shanghai’s children. At this rate, the incidence of type 1 will double in just four years in Shanghai (between 2016 and 2020), and prevalence will sextuple by 2025 (Zhao et al 2014).

What might explain an increasing incidence that is this rapid and this large? The first thing that comes to my mind is pollution. Indeed, air pollution exposure has been linked to type 1 diabetes incidence in children from Los Angeles (Hathout et al. 2006). However, most environmental chemical exposures have not been well studied in type 1 diabetes—or even studied at all (Howard and Lee 2012). The extremely rapid increase of type 1 diabetes incidence in China—in an area where type 1 has traditionally been rare—deserves our full attention. Pollution as a potential cause or contributor to this increase should not be ignored.

Overall, worldwide, type 1 incidence has risen about 3% per year since World War 2 in the children living in industrialized countries (Gale 2002). It is a well-documented increase. Published studies show increasing type 1 incidence from over 60 countries/regions around the world:

Algeria, Argentina, Australia, Austria, Belarus, Belgium, Bosnia and Herzegovinia, Brazil, Bulgaria, Canada, Chile, China, Colombia, Croatia, Cyprus, Czech Republic, Denmark, Dominican Republic, Egypt, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Israel, Italy, Japan, Jordan, Kuwait, Latvia, Libya, Lithuania, Luxembourg, Macedonia, Malta, Mexico, Netherlands, New Zealand, Norway, Peru, Poland, Portugal, Romania, Russia, Saudi Arabia, Singapore, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, Taiwan, Thailand, Tunisia, Turkey, United Kingdom, United States of America, Uruguay, US Virgin Islands.

But these latest number from China show a faster increase than ever before documented. It is time to figure out why.

For more studies on diabetes incidence and prevalence—especially type 1—see my collection in Pubmed. You can download the studies into your reference manager program or just view them in Pubmed.


Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, Bell R, Badaru A, Talton JW, Crume T, et al. 2014. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA 311(17):1778-1786.

Gale EA. 2002. The rise of childhood type 1 diabetes in the 20th century. Diabetes 51(12):3353-3361.

Hathout EH, Beeson WL, Ischander M, Rao R, Mace JW. 2006. Air pollution and type 1 diabetes in children. Pediatric Diabetes 7(2):81-87.

Howard SG, Lee DH. 2012. What is the role of human contamination by environmental chemicals in the development of type 1 diabetes? Journal of Epidemiology and Community Health 66(6):479-481.

Zhao Z, Sun C, Wang C, Li P, Wang W, Ye J, Gu X, Wang X, Shen S, Zhi D, et al. 2014. Rapidly rising incidence of childhood type 1 diabetes in Chinese population: epidemiology in Shanghai during 1997-2011. Acta Diabetologica.

One thought on “Type 1 Diabetes Incidence Skyrocketing in China

  1. Pingback: 1.1 What if Chronic Illness is an Intelligent Process Gone Awry? Insights from Type 1 Diabetes - Chronic Illness Trauma Studies

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