{"id":15213,"date":"2026-06-12T19:00:28","date_gmt":"2026-06-12T19:00:28","guid":{"rendered":"https:\/\/www.dcberne.com\/?p=15213"},"modified":"2026-06-14T20:16:22","modified_gmt":"2026-06-14T20:16:22","slug":"dcb-newsletter-3-26-did-you-know-why-type-1-diabetes-is-rising-and-what-projections-to-2050-tell-us","status":"publish","type":"post","link":"https:\/\/www.dcberne.com\/en\/dcb-newsletter-3-26-did-you-know-why-type-1-diabetes-is-rising-and-what-projections-to-2050-tell-us\/","title":{"rendered":"DCB Newsletter #3\/26: DID YOU KNOW\u2026 why type 1 diabetes is rising and what projections to 2050 tell us?"},"content":{"rendered":"

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Dear Community,<\/em><\/p>\n

We are happy to provide you with a new episode of our \u201cDID YOU KNOW\u2026\u201d series \u2013 this time with a focus on the long\u2011term rise in type 1 diabetes incidence and what current projections tell us about the coming decades.<\/em><\/p>\n

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For much of the 20th century, type 1 diabetes (T1D) was regarded as a relatively stable autoimmune condition. That picture has changed.<\/p>\n<\/blockquote>\n

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Across North America and Europe, the number of children, adolescents and adults newly diagnosed with T1D has been increasing for decades and the COVID\u201119 pandemic appears to have disrupted an already rising curve. With the latest IDF Diabetes Atlas (11th edition, 2025) and the Global Burden of Disease (GBD) 2021 projections to 2050, we now see a clearer, if sobering, outlook.<\/span><\/p>\n

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United States<\/h3>\n

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The SEARCH for Diabetes in Youth study remains the key source for paediatric incidence in the U.S. In 2017\u20132018, annual T1D incidence among people under 20 years reached 22.2 per 100,000, reflecting an average yearly increase of about 2% since 2002\u20132003. CDC estimates suggest that in 2025 around 1.7 million U.S. adults are living with T1D, together with roughly 304,000 youth under 20 \u2013 an increase in overall T1D prevalence of about 30% since 2017. The steepest relative increases have been observed among Hispanic and Black youth.<\/p>\n

Adult trends are more mixed. One large longitudinal analysis from 2001\u20132015 found a slight decline in adult T1D incidence (\u22121.3% per year), while youth incidence continued to rise. This divergence hints that the precipitating factors for childhood\u2011onset and adult\u2011onset T1D may differ.<\/p>\n

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Germany and Austria<\/h3>\n

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In Germany, the DPV registry and the North Rhine\u2011Westphalia (NRW) registry have followed T1D incidence in children under 15 since the 1990s. Over the 2010s, incidence rose by roughly 3\u20134% per year, with signs of a plateau just before the pandemic. COVID\u201119 disrupted that plateau: DPV data show a wave\u2011like pattern of higher\u2011than\u2011expected incidence followed by partial reversion toward the mean between 2020 and 2023. In NRW, 2020 incidence reached about 29.2 per 100,000 person\u2011years \u2013 the highest level reported so far in Germany.<\/p>\n

Austria offers one of the longest\u2011running nationwide paediatric T1D registries, active since 1989. Between 1989 and 2011, incidence in children under 15 increased with an annual percent change of +4.6%. From 2011 to 2020, the trend flattened \u2013 only to jump to a record 28.7 per 100,000 person\u2011years in 2021, closely paralleling the German experience. For the first time, paediatric type 2 diabetes incidence in Austria is also rising in a statistically significant way.<\/p>\n

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Switzerland<\/h3>\n

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Switzerland does not yet have a single integrated national T1D registry, but health\u2011claims data and participation in DPV\/DIVE allow robust estimates. Approximately 40,000 people are currently living with T1D in Switzerland. Historical analyses from the late 20th century documented an absolute incidence increase of 0.67 cases per 100,000 per year between 1965 and 1996 \u2013 a relative annual rise of about 3.4% \u2013 with a particularly steep climb among children under five. Recent Swiss data still point to an upward but moderate trend, consistent with patterns in Germany and Austria.<\/p>\n

From a Swiss perspective, one conclusion is clear: establishing a fully integrated national paediatric and adult T1D registry remains an important unmet need for epidemiology, health\u2011system planning and research.<\/p>\n

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Scandinavia, France, and other high\u2011incidence countries<\/h3>\n

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The Nordic region remains the global hotspot for childhood\u2011onset T1D. Finland has historically reported the highest incidence worldwide \u2013 around 60 per 100,000 children per year \u2013 although this rate appears to have stabilised or slightly declined since the early 2000s. Sweden, Norway and Denmark follow closely, and the IDF Diabetes Atlas 11 still places Finland, Sweden and Norway among the global top ten for published incidence.<\/p>\n

A 2024 systematic review of European paediatric data (1994\u20132022) confirmed that the Nordic countries retain the highest absolute incidence in Europe, even as their rate of increase has slowed relative to the rapid rise in previously low\u2011incidence Central and Eastern European countries. A Swedish nationwide cohort study of 2.9 million children found that the heritability of childhood\u2011onset T1D has remained high and stable at around 0.83 over 30 years, implying that known environmental factors explain less than 10% of the observed rise.<\/p>\n

In France, Sant\u00e9 publique France reports an annual T1D incidence increase of approximately 4%. Paediatric incidence rose from 15.4 to 19.1 per 100,000 person\u2011years between 2010 and 2015, with an overall rate of 19.5 per 100,000 in 2015\u20132017 and substantial regional variation. Sardinia (Italy) now reports the world\u2019s highest published paediatric incidence at 76.3 per 100,000 (2022), having overtaken Finland, while the United Kingdom and Ireland also remain in the global top ten.<\/p>\n

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Projections to 2050<\/h3>\n

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Two major modelling efforts suggest the same direction of travel. The GBD 2021 study projects that age\u2011standardised global type 1 diabetes prevalence will rise by about 23.9% between 2021 and 2050, a smaller relative increase than for type 2 diabetes, but a substantial absolute rise given the lifelong management burden of T1D. The IDF Diabetes Atlas 11 projects that overall adult diabetes prevalence (type 1 and type 2) will grow from 589 million in 2024 to around 853 million by 2050, a 46% absolute increase. While most of this growth is driven by type 2 diabetes, T1D contributes meaningfully through sustained or rising incidence in high\u2011income countries and improved survival, which increases prevalence even if incidence stabilises.<\/p>\n

For the U.S., a modelling exercise based on SEARCH data suggests that, under a linear\u2011increase scenario, the number of young people with T1D could nearly triple by 2050, with the steepest relative growth among Hispanic and Black children.<\/p>\n

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Why is incidence rising?<\/h3>\n

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T1D is a polygenic autoimmune disease in which environmental triggers act on a susceptible genetic background. Several, often overlapping, hypotheses are under investigation:<\/p>\n