New Study Reveals Shifting Patterns in Childhood Type 1 Diabetes Diagnosis in Serbia

A 25-year analysis shows that while Type 1 diabetes diagnoses in children have increased significantly, the rate of increase has recently slowed. However, more children are arriving at diagnosis with diabetic ketoacidosis, a serious complication.

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Key takeaways

The rate of new Type 1 diabetes diagnoses in Serbian children more than doubled over 25 years, rising from 9.7 to 25.5 cases per 100,000 children between 2000 and 2021.
The increase in diagnoses slowed around 2016 in younger children (ages 0–14), suggesting the rate may be stabilizing in that group.
About 42% of children presented with diabetic ketoacidosis (DKA) at diagnosis, with higher rates during and after the COVID-19 pandemic.
There was no clear seasonal pattern in when children were diagnosed with Type 1 diabetes, contrary to findings in some other regions.

A Quarter-Century of Increasing Diagnoses

Researchers in Serbia tracked Type 1 diabetes diagnoses in children and adolescents from 2000 to 2024, analyzing data from 15 pediatric centers across the country. Over this 25-year period, they identified 4,335 new cases and found a significant upward trend in how often Type 1 diabetes is diagnosed in young people.

The incidence—the number of new cases per 100,000 children per year—climbed steadily from 9.7 in 2000 to 25.5 in 2021, an increase of more than 150%. This rise reflects a pattern seen in many developed countries, where Type 1 diabetes diagnoses have been increasing for decades.

Early Signs of Stabilization

While the overall trend shows growth, there are signs that the rate of increase may be slowing. Among the youngest children studied (ages 0–14), the rate of new diagnoses climbed sharply until 2016, then leveled off through 2024. This plateau suggests that in younger age groups, the frequency of new Type 1 diabetes diagnoses may be stabilizing, though researchers emphasize that longer observation is needed to confirm this pattern.

The reason for this potential stabilization remains unclear and is an important question for future research.

No Clear Seasonal Pattern

Some previous studies have suggested that Type 1 diabetes diagnoses cluster in certain seasons, possibly linked to viral infections or other environmental factors. However, this Serbian analysis found no statistically significant seasonal variation in the timing of new diagnoses over the 25-year period, suggesting that seasonal factors may not play a major role in when children develop Type 1 diabetes in this population.

Rising Concern: DKA at Diagnosis

A troubling finding emerged regarding diabetic ketoacidosis (DKA), a serious and potentially life-threatening complication that can occur when Type 1 diabetes goes undiagnosed or untreated. Overall, 42.4% of newly diagnosed children in this study presented with DKA.

The rate of DKA at diagnosis rose noticeably during the COVID-19 pandemic, reaching 47.7%, and has remained elevated even after the pandemic. This suggests that pandemic-related disruptions to healthcare access or delays in seeking medical care may have had lasting effects on how sick children are when they are finally diagnosed with Type 1 diabetes.

What This Means for Families

These findings underscore the importance of recognizing the symptoms of Type 1 diabetes early—including increased thirst, frequent urination, unexplained weight loss, and fatigue—and seeking medical attention promptly. Early diagnosis before DKA develops is associated with better health outcomes and can prevent a serious medical emergency.

The data also highlight the ongoing need for public awareness about Type 1 diabetes symptoms and the importance of access to timely healthcare, particularly as pandemic-related healthcare disruptions have shown their lasting impact on the timing and severity of diagnoses.

Evidence label

Source: Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.

Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.

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