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American Journal of Epidemiology Vol. 124, No. 4: 545-560
Copyright © 1986 by The Johns Hopkins University School of Hygiene and Public Health

research-article

THE DISTRIBUTION OF TYPE I (INSULIN-DEPENDENT) DIABETES MELLITUS BY AGE, SEX, SECULAR TREND, SEASONALITY, TIME CLUSTERS, AND SPACE-TIME CLUSTERS: EVIDENCE FROM MONTREAL, 1971–1983

JACK SIEMIATYCKI1,2,, ELEANOR COLLE3, DENIS AUBERT1, SALLY CAMPBELL1 and MIMI M. BELMONTE3

1Centre de recherche en épidémiologie et médecine préventive, Institut Armand-Frappier 531 boul. des Prairies, Laval-des-Rapides, Quebec H7V 1B7 Canada
2Department of Epidemiology and Biostatistics, McGill University Montreal, Quebec, Canada
3Montreal Children's Hospital, McGill University Research Institute Montreal, Quebec, Canada

Reprint requests to Dr. Jack Siemiatycki.

The etiology of insulin-dependent diabetes mellitus remains obscure. In an attempt to clarify some aspects of the epidemiology, including its compatibility with an acute infectious process, the authors undertook in-depth analyses of childhood cases accumulated in a population-based register in Montreal during the period from 1971-1983. Incidence rates increased with age until puberty, at which point they plateaued and decreased. There was no overall difference in incidence between males and females; however, the rate for females peaked approximately two years before the rate for males. While there was some variation overtime, there was no evidence of a long-term trend, nor was the yearly variation impressive in magnitude. The findings further indicate that the disease is not characterized by explosive outbreaks. There was slight seasonality, with a 28% higher rate of onset in fall and winter than in spring and summer. There was some evidence of space-time clustering in 1971–1973, but not thereafter. Taken as a whole, these findings do not support the hypothesis that a significant portion of insulin-dependent diabetes is caused by an acute infectious process.

diabetes mellitus; sex; space-time clustering; time factors


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