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Table 1 Systematic review of T1D in adults, diagnostic criteria and sources of information

From: Global epidemiology of type 1 diabetes in young adults and adults: a systematic review

Study information T1D diagnosis criteria in adults and young adults Source of information and validation of ascertainment between sources
Country, area reported in the article First author, publication year Ref Age range Period Detect. AA/C-Peptide Need of insulin therapy Administration insulin therapy Clinical impression Ketosis/ ketonuria Weight loss Primary Secondary Tertiary % of ascertainment
African Region, LMIC
Mauritius: NW Tuomileht J., 1993 [13] 0-19 1986-1990 No Yes From diagnosis Yes NA NA Medical reports Medical statistics NA 95.0
United Republic of Tanzania: Dar es Salaam Swai A. B., 1993 [14] 0-19 1982-1991 No Yes From diagnosis Yes NA NA Medical reports Hospital records NA NA
Eastern Mediterranean Region, LMIC
Iran (Islamic Republic of): Fars Pishdad G. R., 2005 [15] 0-29 1990-1994 Yes (a) Yes From diagnosis Yes Yes Yes Medical reports from endocrinologists Medical records NA 100
Libyan Arab Jamahiriya: Benghazi Kadiki O. A., 1996 [16] 0-34 1981-1990 No Yes From diagnosis NA Yes NA National Diabetes Program Hospital registers NA 95.0
Tunisia: Beja, Monastir, Gafsa Ben Khalifa F., 1998 [17] 0-19 1990-1994 No Yes From diagnosis Yes NA NA Hospital records School health centers NA 96.0
European Region, LMIC
Croatia: Zagreb Roglic G., 1995 [18] 0- > 55 1988-1992 No Yes Within 1 week of diagnosis Yes Yes NA National Diabetes Program Death certificates Diabetes association 96.2
Estonia: NW Kalits I., 1990 [19] 0- > 50 1988-1988 No Yes From diagnosis Yes Yes Yes NA NA NA NA
Lithuania: NW Ostrauskas R., 2011 [20] 15-34 1991-2008 No Yes Within 2 weeks of diagnosis Yes Yes Yes National Diabetes Program Regional endocrinologist Notes of patient insurance 86.8
Lithuania: NW Pundziute-Lycka A., 2003 [21] 0-39 1991-2000 No Yes Within 2 weeks of diagnosis Yes Yes NA National Diabetes Program Pediatrician and endocrinologist reports Death certificates 91.2
Lithuania: NW Ostrauskas R., 2000 [22] 15-39 1991-1997 No Yes Within 2 weeks of diagnosis Yes Yes NA National Diabetes Program Pediatrician and endocrinologist reports Death certificates 91.2
Poland: Bialystok Kretowski A., 2001 [23] 0-29 1994-1998 No Yes From diagnosis Yes Yes Yes Pediatric and Internal medicine records Hospital discharge registers NA 98.5
Poland: Province of Rzeszow Sobel-Maruniak A., 2006 [24] 0-29 1980-1999 No Yes From diagnosis Yes NA NA Pediatric and Internal medicine records Others health care registers NA 99.0
Poland: Province of Rzeszow Grzywa M. A., 1995 [25] 0-29 1980-1992 No Yes From diagnosis Yes NA NA Pediatric and Internal medicine records Others health care registers NA 99.0
Poland: Warsaw Wysock M. J., 1992 [26] 0-29 1983-1988 No Yes From diagnosis Yes NA NA Medical records from diabetic clinics General practitioners and diabetologist registers Death certificates NA
Romania: Bucharest Ionescu-Tirgoviste C., 1994 [27] 0- ≥ 85 1981-1991 No Yes From diagnosis Yes Yes NA Bucharest Diabetes Registry NA NA NA
Slovakia: NW Kyvik K O, 2004 [28] 15-29 1996-1997 No Yes From diagnosis Yes NA NA Pediatrician and endocrinologist reports Other health care registers NA 80.0
European Region, HIGH
Austria: Upper Rami B., 2001 [29] 0-29 1994-1996 No Yes From diagnosis Yes NA NA Pediatricians and endocrinologists reports Austrian Diabetes Association NA 87.0
Belgium: Antwerp Weets I., 2007 [30] 0-39 1989-2003 Yes Yes From diagnosis Yes NA NA Pediatricians and endocrinologists reports General practitioners and diabetes nurses reports Diabetes associations and self-reporting 97.0
Belgium: Antwerp Weets I., 2002 [31] 0-39 1989-2000 Yes Yes From diagnosis NA NA NA Pediatrician and endocrinologist reports General practitioner and diabetes nurse reports Diabetes associations and self-reporting 93
Belgium: Antwerp Vandewalle C., 1997 [32] 0-39 1989-1995 Yes Yes From diagnosis Yes Yes Yes Pediatrician and endocrinologist reports General practitioner and diabetes nurse reports Diabetes associations and self-reporting 85
Bosnia and Herzegovina: Republic of Srpska Radosevic B., 2013 [33] 0-18 1998-2010 No Yes From diagnosis Yes NA NA Hospital records Insulin prescription registers NA 100
Denmark: Copenhagen and Frederiksborg Molbak A. G., 1994 [34] 30-95 1973-1977 Yes (b) Yes From diagnosis Yes Yes Yes Hospital discharges General practitioners and diabetologist registers and death certificates Missing coding of T1D diagnosis in hospital admissions 99.0
Finland: NW Lammi N., 2007 [35] 15-39 1992-1996 Yes Yes From diagnosis Yes NA NA National Diabetes Program Hospital discharge registers Drug reimbursement registers 88.0
France: Aquitaine, Lorraine, Basse Normandie, Haute Normandie Charkaluk M. L, 2002 [36] 0-19 1988-1997 No Yes None declared NA NA NA Prospective registers French Social Security registers NA 96.0
France: Aquitaine, Lorraine, Basse Normandie, Haute Normandie Levy-Marchal, C., 1998 [37] 0-19 1988-1995 No Yes None declared NA NA NA Prospective registers French Social Security registers NA 96.0
Israel: NW Blumenfeld O., 2014 [38] 0-17 1997-2010 No Yes From diagnosis Yes NA NA Israel juvenile diabetes register Israel Center for Disease Control NA NA
Israel: NW Sella T., 2011 [39] 0-17 2000-2008 No Yes None declared Yes NA NA Israel juvenile diabetes register Israel Center for Disease Control NA NA
Israel: NW Koton S., 2007 [40] 0-17 1997-2003 No Yes From diagnosis Yes NA NA Israel juvenile diabetes register NA NA NA
Italy: Lombardie Garancini, P., 1991† [41] 0-34 1981-1982 No Yes None declared NA NA NA Hospital discharge records Hospital admission records NA 85.7
Italy: Pavia Tenconi M. T., 1995 [42] 0-29 1988-1992 No Yes From diagnosis Yes NA NA Hospital records Drug registers NA 100
Italy: Sardinia Muntoni S, 1992 [43] 0-29 1989-1990 No Yes From diagnosis Yes NA NA Hospital records Diabetes association NA 92.8
Italy: Sardinia (Oristano) Frongia O., 1997 [44] 0-29 1993-1996 No Yes From diagnosis Yes NA NA Hospital records Drug registers NA 100
Italy: Turin Bruno G., 2009 [45] 15-29 2000-2004 Yes Yes Within 6 months of diagnosis NA NA NA Hospital records Drug registers NA NA
Italy: Turin Bruno G., 2005 [46] 30-49 1999-2001 Yes Yes Within 6 months of diagnosis NA Yes NA Diabetes clinics Drug registers NA 99.0
Italy: Turin Bruno G., 1993 [47] 0-29 1984-1988 No Yes From diagnosis NA Yes NA Diabetic clinics records Hospital discharge records NA 97.0
Luxembourg: NW De Beaufort C. E., 1988 [48] 0-19 1977-1986 No Yes None declared NA NA NA Pediatric and Internal medicine records Dutch Diabetes Association NA 100
Malta: NW Schranz A. G., 1989 [49] 0-24 1980-1987 No Yes Within 3 moths of diagnosis Yes Yes Yes Medical reports Diabetic clinic records NA NA
Netherlands: NW Ruwaard D., 1994 [50] 0-19 1988-1990 No Yes None declared NA NA NA Pediatric and Internal medicine records NA NA 81.0
Norway: NW Joner G., 1991 [51] 15-29 1978-1982 No Yes From diagnosis NA NA NA Pediatricians and endocrinologists reports Hospital records NA 90.0
Slovenia: NW Radosevic B., 2013 [33] 0-18 1998-2010 No Yes From diagnosis Yes NA NA Slovenian National Registry of Childhood diabetes Insulin prescription registers NA 100
Spain: Badajoz Morales-Perez F. M., 2000 [52] 0-29 1992-1996 No Yes From diagnosis Yes Yes NA Pediatricians and endocrinologists reports Diabetic clinic records NA 95.0
Spain: Canarias Islands Carrillo Dominguez, A., 2000 [53] 0-30 1995-1996 No Yes None declared Yes NA Yes Hospital records and Endocrinologist reports Diabetes association reports and sales on blood glucose monitors NA 90.1
Spain: Catalonia Abellana R., 2009 [54] 0-29 1989-1998 Yes (c) Yes From diagnosis Yes Yes NA Catalan Registry of Type 1 Diabetes Summer camps, associations, and prescription data NA 90.0
Spain: Catalonia Goday A., 1992 [55] 0-29 1987-1990 No Yes From diagnosis Yes NA NA Catalan Registry of Type 1 Diabetes Summer camps, patient associations, and prescription data NA 90.1
Spain: Navarra Forga L., 2014 [56] 0- > 45 2009-2012 Yes Yes Within 6 months of diagnosis Yes Yes NA Hospital records Electronic medical records, diabetes associations NA 98.4
Spain: Navarra Forga L., 2013 [57] 0-79 2009-2011 Yes Yes Within 6 months of diagnosis Yes Yes NA Hospital records Electronic medical records, diabetes associations NA 98.4
Sweden: NW Dahlquist G. G., 2011 [58] 0-34 1983-2007 No Yes From diagnosis Yes Yes Yes National Diabetes Program Pediatricians and endocrinologist reports NA 96.0
Sweden: NW Östman J., 2008 [59] 15-34 1983-2002 No Yes From diagnosis Yes NA NA National Diabetes Program Pediatrician and endocrinologist reports Computer-based patient administrative register 82
Sweden: NW Pundziute-Lycka A., 2002 [60] 0-34 1983-1998 No Yes From diagnosis Yes Yes Yes National Diabetes Program Pediatrician and endocrinologist reports Computer-based patient administrative register 91.2
Sweden: NW Nyström L., 1992 [61] 0-34 1983-1987 No Yes None declared NA NA NA National Diabetes Program Hospital admission and discharge registers NA 89
Sweden: NW Blohme G., 1992 [62] 15-34 1983-1987 No Yes From diagnosis Yes Yes Yes National Diabetes Program Hospital admission and discharge registers NA NA
Sweden: Kronoberg Thunander M., 2008 [63] 0-100 1998-2001 Yes Yes Within 4 weeks of diagnosis Yes Yes NA Opportunistic screening of all adult patients in contact with the medical care system Departments of ophthalmology NA 98.0
United Kingdom: NW Imkampe A. K., 2011 [64] 0-34 1991-2008 No Yes Within 3 moths of diagnosis Yes NA NA National Diabetes Program Pediatricians and endocrinologist reports NA NA
United Kingdom: Oxford region Bingley P. J., 1989 [65] 0-21 1985-1986 No Yes From diagnosis Yes NA NA Medical reports from general practioners and pediatricians Regional hospital records NA 95.0
Region of the Americas, LMIC
Barbados: NW Jordan O. W., 1994 [66] 0-29 1982-1991 No Yes From diagnosis Yes NA NA Hospital records Others health care registers NA 94.0
Region of the Americas, HIGH
Canada: Quebec Legault L., 2006 [67] 0-18 2000 No Yes None declared NA NA NA Departmental program: Régie des Rentes du Québec program NA NA NA
United States of America: Alabama (Jefferson County) Wagenknecht L. E., 1991 [68] 0-19 1979-1988 No Yes None declared NA NA NA Hospital records Summer camps, patient associations, and prescription data NA NA
United States of America: Alabama (Jefferson County) Wagenknecht L. E.,1989 [69] 0-19 1979-1985 No Yes From diagnosis Yes NA NA Hospital records Association registers NA 95.0
United States of America: Colorado Vehik K., 2007 [70] 0-17 2000-2004 No Yes Within 2 weeks of diagnosis Yes NA NA Pediatricians and endocrinologists reports Other health care registers The SEARCH Study 96.5
United States of America: Colorado Kostraba J. N., 1992 [71] 0-17 1978-1988 No Yes Within 2 weeks of diagnosis Yes NA NA Pediatricians and endocrinologists reports Hospital registers NA 93.3
United States of America: Pennsylvania (Allegheny) Libman I. M., 1998 [72] 0-19 1990-1994 No Yes From diagnosis Yes NA NA Medical reports General practitioners and diabetes nurses reports NA 97.7
United States of America: Rhode Island Fishbein H. A., 1982 [73] 0-29 1979-1980 No Yes None declared NA NA NA Medical reports Insulin prescription registers NA NA
United States of America: five areas § Bell R., 2009 [74] 0-19 2002-2005 Yes Yes From diagnosis Yes NA NA Medical reports Other health care registers The SEARCH Study NA
United States of America: Wisconsin Allen C., 1986 [75] 0-29 1970-1979 No Yes From diagnosis Yes NA NA Hospital discharges Pediatricians and endocrinologist reports NA 90.0
United States of America: The United States Navy Gorham C., 1993 [76] 17-34 1974-1988 No NA* None declared Yes NA NA Hospital discharges NA NA NA
Western Pacific Region, HIGH
Australia: New South Wales Tran F., 2014 [77] 10-18 2001-2008 No Yes NA Yes NA Yes Endocrine group diabetes register National diabetes register NA 96.0
Australia: Sydney (Southern Metropolitan Health Region) Sutton L., 1989 [78] 0-19 1984-1987 No Yes From diagnosis Yes NA NA Medical reports from general practioners and pediatricians Schools in the area Syringe register NA
Japan: Osaka Sasaki A., 1992 [79] 0-18 1978-1988 No Yes None declared Yes Yes NA Medical benefits system NA NA NA
New Zealand: Canterbury Scott, R. S., 1991 [80] 0- ≥ 80 1981-1986 No Yes Within 1 year of diagnosis Yes NA Yes Community-based surveys administrated in pharmacies where diabetic patients acquired their insulin supplies Hospital admission and discharge registers and diabetologist NA 95.0
Other Regions currently non WHO
Taiwan: NW Lin W.-H., 2013 [81] 0- ≥ 60 1999-2010 Yes Yes None declared Yes Yes NA National Health Insure register and Illness certificates Random sample of a database used to reimbursements NA 98.3
US Virgin Islands: NW Washington R. E., 2013 [82] 0-19 2001-2010 No Yes From diagnosis Yes Yes Yes Medical reports Medical providers NA 98.7
  1. WHO Member States are divided into high-income (HIGH) or low- and middle-income (LMIC) states [30]. AA: autoantibodies, NW: Nation-wide study, NA: Unavailable data. (a) When there were diagnostic doubts, (b) Only for patients aged over 40 years at onset, (c) Not performed in all cases; the author of this study was contacted to confirm the proportion of these cases, but by the time of submission of this paper no answer was available. T1D: Type 1 Diabetes. Highlighted: reports of the systematic review using the autoantibodies/C-peptide as diagnosis criteria. () Studies used in the statistical analyses. (*) Data were not available but researchers assumed that patients have had T1D based on their average of age. (§) Ohio (8 counties), Washington State (5 counties), South Carolina, Colorado, California.