Comparison of anti-diabetic drug prescribing in children and adolescents in seven European countries

Aims The aim of this study was to compare the prevalence of diabetes in children across seven European countries, when using prescribing of anti-diabetics as a proxy for diabetes. A secondary aim was to assess the potential for collaboration between countries using different databases in diabetes research. Methods Data were obtained from population-based clinical databases in seven European countries. The study population comprised children aged 0-18 years. Prescriptions were categorized using Anatomic-Therapeutic-Chemical (ATC) Classification. One-year user prevalence in 2008 was calculated for each country and stratified by age and gender. Results We studied a total of 5.8 million children and adolescents. The prevalence of insulin prescribing varied between 1.1 and 3.5 per 1,000 individuals being highest in Sweden and lowest in Italy. In all countries novel insulin analogues were the most commonly used insulins. The prevalence of oral anti-diabetic prescribing ranged from 0.08 per 1,000 individuals in Sweden and Germany to 0.21 per 1,000 individuals in the UK. Overall, the absolute number of oral antidiabetic users was very low. Conclusion This study shows that there is a varying frequency of type 1 diabetes in children and adolescents across Europe. We also demonstrated that it is possible to obtain similar information from different clinical databases within Europe which would allow continuous monitoring of type 1 diabetes. Because of the lack of indications in most of the databases, this approach is less suitable for type 2 diabetes.