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American Journal of Epidemiology Vol. 129, No. 3: 569-581
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

POISSON REGRESSION MODELING OF TEMPORAL VARIATION IN INCIDENCE OF CHILDHOOD INSULIN-DEPENDENT DIABETES MELLITUS IN ALLEGHENY COUNTY, PENNSYLVANIA, AND WIELKOPOLSKA, POLAND, 1970-1985

MARIAN REWERS1,2, ROSLYN A. STONE3, RONALD E. LAPORTE2, ALLAN L. DRASH4, DOROTHY J. BECKER4, MIECZYSLAW WALCZAK1 and LEWIS H. KULLER2

Diabetes Research Center Pittsburgh, PA 15213
1Department of Pediatrics, Academy of Medicine Poznan, Poland
2Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA
3Department of Clinical Epidemiology and Preventive Medicine, School of Medicine, and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA
4Division of Endocrinology, Department of Pediatrics, School of Medicine, University of Pittsburgh Pittsburgh, PA

Contradictory observations have accumulated regarding a secular trend and/ or an epidemic pattern in the incidence of insulin-dependent diabetes mellitus. In this study, insulin-dependent diabetes mellitus incidence below age 15 years was examined in Allegheny County, Pennsylvania, and in Wielkopoiska, Poland, two areas diverse in terms of their geography and average risk for this disease. Numerator data were extracted from individual patient records, and annual denominator data were available for the years 1970–1985. Poisson regression models were used to disentangle the contributions of country, race, sex, age, period, and cohort effects to the observed variation in incidence. Poles and Allegheny County nonwhites were at greatly and moderately reduced tisk, respectively, relative to Allegheny County whites. An increase in risk with age was significant and proportional in all three groups. There was significant time varia bility in Wielkopoiska, where an epidemic began in 1982 and continued through 1985. This was a period rather than a cohort phenomenon and was a result of a recent outbreak of the disease rather than a long-term trend. In Allegheny County, changes in risk over the 16-year period were insignificant, although incidence doubled among whites aged 0–9 years during 1982–1983. The Poisson regression modeling provided a quantification and formal comparison of determinants of the incidence of insulin-dependent diabetes mellitus.

diabetes mellitus, insulin-dependent; statistics; time factors


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