Divergent trends in the incidence of end-stage renal disease due to Type 1 and Type 2 diabetes in Europe, Canada and Australia during 1998–2002.

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    • Abstract:
      Aims To describe the variation in geographical distribution of end-stage renal disease (ESRD) due to Type 1 and Type 2 diabetes, and to calculate recent trends in incidence in predominantly white populations. Methods Estimation of age- and sex-standardized incidence of ESRD by type of diabetes, and temporal trends, in population-based data for persons aged 30–44, 45–54 or 55–64 years newly treated for ESRD during 1998–2002 in eight countries or regions of Europe, and Non-Indigenous Canadians and Australians. Results The incidence of ESRD due to Type 1 diabetes at age 30–44 years correlated with published rates of childhood-onset insulin dependent diabetes mellitus ( P = 0.0025). ESRD due to Type 2 diabetes was uncommon before 45 years of age; in older persons, the highest rates (in Canada and Austria) were five times the lowest rates (in Norway and the Basque region). Rates of ESRD due to Type 1 diabetes fell, per year, by 6.4%[95% confidence interval (CI): 2.1–10.6%) in persons aged 30–44 years, and by 7.7% (95% CI: 2.4–12.7%] in those aged 45–54 years. In contrast, rates of ESRD due to Type 2 diabetes increased annually by 16% (95% CI: 5–28%) in the 30–44-year age group, 11% (95% CI: 6–16%) at 45–54 years, and 9% (95% CI: 5–14%) at 55–64 years. Conclusions Modern prevention has reduced progression of nephropathy to ESRD due to Type 1 diabetes, but the continuing rise of ESRD due to Type 2 diabetes represents a failure of current disease control measures that has serious public health implications. [ABSTRACT FROM AUTHOR]
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