Chronic comorbidities in children with type 1 diabetes: a population-based cohort study

Arch Dis Child. 2015 Aug;100(8):763-8. doi: 10.1136/archdischild-2014-307654. Epub 2015 Apr 15.


Objective: To determine the incidence of chronic comorbidities among children with type 1 diabetes (T1D) and to compare incidences with a group of children without diabetes.

Design: Population-based cohort study.

Setting: Dutch PHARMO database (1998-2010).

Patients: All patients (<19 years old) with T1D between 1999 and 2009 (T1D cohort) and a group of age- and sex-matched (ratio: 1-4) children without diabetes (reference cohort).

Main outcome measure: The incidence of nine common chronic comorbidities was assessed on the basis that they were treated pharmacologically and/or resulted in hospital admission. Cox proportional hazard analysis was used to estimate the strength of the association between T1D and comorbidities, expressed as HRs and 95% CIs.

Results: A total of 915 patients with T1D and 3590 children in the reference cohort (51% boys, mean age of 10.1 (SD 4.5) years) were included. T1D was associated with an increased risk (HR; 95% CI) of hospitalisation for any comorbidity (3.7; 2.5 to 5.5), thyroid disease (14.2; 6.7 to 31.0), non-infectious enteritis and colitis (5.9; 3.0 to 11.5), cardiovascular disorders (3.1; 2.3 to 4.2), mental disorders (2.0; 1.4 to 3.1), epilepsy (2.0; 1.1 to 3.7) and (obstructive) pulmonary disease (1.5; 1.2 to 2.0). There was no significant difference in the incidences of other comorbidities (malignant disorders, anaemia and migraine) between the two cohorts.

Conclusions: Our longitudinal study showed that incidences of six chronic diseases were significantly higher in T1D children during the early years of developing this disease compared with the reference children.

Keywords: Diabetes; Epidemiology.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Chronic Disease / epidemiology*
  • Cohort Studies
  • Comorbidity
  • Databases, Factual
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Infant
  • Male
  • Netherlands / epidemiology