diabetes is one of the most severe forms of the disease. It cannot
be treated by diet, so affected children require daily insulin
injections and frequently suffer complications such as eye or
kidney problems as they get older. And it is becoming more and
more common. The first major pan-European studies into the disease
began in 1985, when the Commission established a network linking
diabetes specialists across Europe. This was used and expanded
by the EURODIAB (Epidemiology and prevention of diabetes) project,
which studied the incidence of childhood diabetes across Europe,
the complications it causes in later life and its general social
The results, published in The Lancet in the early 1990s, was based
on data on 16.8 million children collected in 24 regions across
Europe and Israel. They found enormous variation - from 42.9 annual
cases per 100,000 in Finland to almost ten times less in northern
Greece. Eastern European countries had very low rates - although
subsequent studies (below) have since shown an inexplicable rise.
The next project - EURODIAB ACE (Aetiology of childhood diabetes
on an epidemiological basis) - used genetic and immunological
methods. About 40 different groups worked together, generating
a study population of almost 30 million children.
The results were interesting but painted a complex picture. While
some genetic markers were found much more often in children who
developed diabetes, the evidence pointed to an interplay between
genes and environment, and suggested that this interplay may differ
The latest phase - EURODIAB TIGER (Type I Genetic Epidemiology
Resource) - aims to discover more about the genetic factors and
couple the resulting knowledge with information on environmental
factors such as lifestyle, diet and viral infections.
Once again, the network will be crucial. It now includes 44 institutions
in 28 European nations, and is collecting material from 2,000
patients and their immediate relatives to be analysed for specific
genetic and immune markers in conjunction with PARADIGM, a European
concerted action which is supplying the central analysis facility.
According to project coordinator Anders Green, "This huge collaborative
network is a valuable resource, particularly for Central and Eastern
Europe, which will need the support to cope with their growing
diabetes problem. It must not be wasted."