Type 1 diabetes is the most common form of diabetes in children and adolescents in the majority of countries, but other forms of diabetes also occur, including type 2 diabetes and monogenic diabetes. Type 1 diabetes is a complex condition to manage. Insulin injections are needed for survival and good outcomes can only be achieved with multiple daily injections or the use of an insulin pump. Successful insulin therapy requires self- monitoring of blood glucose, comprehensive diabetes education and the support of skilled health professionals.
Numbers of new (incident) and existing (prevalent) type 1 diabetes cases are increasing each year due to rising incidence in many countries⁷ and reductions in mortality. In total, 1,211,900 children and adolescents younger than 20 years are estimated to have type 1 diabetes globally. It is estimated that around 108,200 children and adolescents under 15 years are diagnosed each year. This number rises to 149,500 when the age range extends to those under 20 years (Table 3.9).
A complementary publication8 provides the incidence data estimated for all countries. Incidence rates are highest in populations of Northern European origin,
as well as in an increasing number of countries in the Middle East and North Africa. Of the ten countries with the highest incidence, four are now from non-European populations (Table 3.10). A recent report from Eritrea demonstrating a high incidence, particularly in the 15–24-year age group, confirms observations among migrant populations from this area in Africa.⁹
Of the 215 countries and territories covered by the IDF Diabetes Atlas, only 97 have their own incidence data.
For most, this is limited to children and adolescents under 15-years of age. Among the countries without data for under 20-year-olds are some very populous nations, such as Nigeria, Indonesia, the Philippines, Vietnam, and South Africa. For these countries data are extrapolated from a nearby country with similar characteristics. However there are various reasons why such data may not be accurate. The African Region is the least complete. However, new data from Gabon,¹⁰ Mali¹¹ and Eritrea,⁹ as well as updated data from Tanzania,¹² have helped fill some of the gaps.
Compared with the 9th Edition of the IDF Diabetes Atlas in 2019, the number of new cases has increased sharply in the AFR and MENA regions due to revisions resulting from recent incidence studies.
Global population (0–14 years) 1.99 billion
Global population (0–19 years) 2.61 billion
Type 1 diabetes in children and adolescents (0–14 years)
Number of prevalent (existing) cases of type 1 diabetes 651,700 Number of incident (new) cases of type 1 diabetes per year 108,300 Type 1 diabetes in children and adolescents (0–19 years)
Table 3.9 Global estimates for type 1 diabetes in children and adolescents (0–14 years and 0–19 years) in 2021.
1
Map 3.4 Age-sex standardised incidence rates (per 100,000 population per annum) of type 1 diabetes in children and adolescents aged 0–14 years
≥30
Age-sex standardised incidence rates (per 100,000 population per annum) of
20-<30
10-<20
5-<10
<5
No data available
<5 5-<10 10-<20 20-<30
≥30
no estimates made
3
Comparable measured prevalence data are only available for 12 countries. Due to the paucity of prevalence data, estimation for all countries was not possible and data from these reports was used to estimate prevalence by region. Rapid changes in mortality, diagnosed incidence, and differences between regions within countries may explain larger discrepancies for Mali,11 Maldives,13 and Canada.14, 15 The EUR and NAC regions have the highest number of prevalent cases due to high incidence rates.
Numbers of people under 20 years of age with type 1 diabetes in AFR have more than doubled since 2019 due to the availability of new data. Figures 3.6 and 3.7 show the breakdown of prevalent and incident cases per IDF Region. By country, India now has the highest estimated number of prevalent type 1 diabetes cases in people under 20 years of age (229,400), followed by USA (157,900) and Brazil 92,300 (Table 3.10).
The IDF Diabetes Atlas Committee encourages all countries to ascertain their current rates of new and existing cases of type 1 diabetes for children and adolescents. The IDF Guide for Diabetes Epidemiological Studies16, provides useful and practical information on how to plan, conduct, and report such studies.
Figure 3.6 Estimated number of children and
adolescents (0–19 years) with prevalent (existing) type 1 diabetes by IDF Region in 2021 (adjusted for mortality)
Figure 3.6
IDF Regions
Thousands
0 50 100 150 200 250 300 350
MENA NAC EUR
AFR WP SACA SEA
13
Figure 3.7 Estimated annual incident (new) cases of type 1 diabetes in children and adolescents (0–19 years) by IDF Region in 2021
Table 3.10 Top 10 countries or territories for estimated number of incident (new) cases of type 1 diabetes in children and adolescents (0–19 years) per annum
Rank Country or territory Number of incident (new) cases (0–19 years) in thousands
1 India 24.0
2 United States of
America 18.2
3 Brazil 8.9
4 Algeria 6.5
5 China 6.1
6 Moroccoi 5.1
Table 3.11 Top 10 countries or territories for estimated number of prevalent (existing) cases of type 1 diabetes in children and adolescents (0–19 years) per annum
Rank Country or territory Number of children and adolescents with type 1 diabetes (0–19 years) in thousands
1 India 229.4
2 United States of
America 157.9
3 Brazil 92.3
4 China 56.0
5 Algeria 50.8
6 Moroccoi 43.3
7 Russian Federation 38.1
8 Germany 35.1
9 United Kingdom 31.6
10 Saudi Arabia 28.9
Table 3.12 Top 10 countries or territories for incidence rates (per 100,000 population per annum) of type 1 diabetes in children (0–14 years)
Rank Country or territory Incidence rates (per 100,000 population per year) 0–14 years
1 Finland 52.2
2 Sweden 44.1
i The figure for Morocco uses incidence rates extrapolated from Algeria
0
IDF Regions
Thousands
5 10 15 20 25 30
35 Figure 3.7
MENA NAC AFR SACA WP EUR SEA
1
0.1 10 100
Incidence of type 2 diabetes, per 100,000, per year Germany (1999-2008)
New Zealand (White) (2008-2015) UK (White) (2015-2016) Finland (1992-1996) Austria (2017) UK (Whole population) (2015-2016) Russia (2016) Maldives (2009-2018) Australia (Non-indigenous People) (2012) Canada (Whole population) (2006-2008) UK (Black) (2015-2016) Korea (2010) New Zealand (Whole population) (2008-2015) Kuwait (2011-2013) Qatar (2012-2016) UK (South Asians) (2015-2016) Japan (2015) Australia (Whole population) (2012) Sweden (1998-2001) New Zealand (Maori) (2008-2015) China (2013) New Zealand (Pacific Islander) (2008-2015) US (White) (2014-2015) Hungary (2016) Korea (2010-2013) Taiwan (1999) Hong Kong SAR, China (2015) US (Whole population) (2014-2015) Thailand (1997-1999) US (Hispanic) (2014-2015) Australia (Indigenous people) (2012) US (American Indian) (2014-2015) US (Black) (2014-2015) US (Navajo Nation People) (2010-2013) Canada (First Nation People) (2014-2015)
1
Figure 3.9