scholarly journals Type 1 diabetes in 2017: global estimates of incident and prevalent cases in children and adults

Diabetologia ◽  
2021 ◽  
Author(s):  
Anders Green ◽  
Simone M. Hede ◽  
Christopher C. Patterson ◽  
Sarah H. Wild ◽  
Giuseppina Imperatore ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age Groups ◽  
Incidence Rates ◽  
Data Availability ◽  
Sensitivity Analyses ◽  
Estimation Methods ◽  
Diabetes Incidence ◽  
Incident Cases ◽  
The Impact

Abstract Aims/hypothesis Data on type 1 diabetes incidence and prevalence are limited, particularly for adults. This study aims to estimate global numbers of incident and prevalent cases of type 1 diabetes in 2017 for all age groups, by country and areas defined by income and region. Methods Incidence rates of type 1 diabetes in children (available from 94 countries) from the IDF Atlas were used and extrapolated to countries without data. Age-specific incidence rates in adults (only known across full age range for fewer than ten countries) were obtained by applying scaling ratios for each adult age group relative to the incidence rate in children. Age-specific incidence rates were applied to population estimates to obtain incident case numbers. Duration of diabetes was estimated from available data and adjusted using differences in childhood mortality rate between countries from United Nations demographic data. Prevalent case numbers were derived by modelling the relationship between prevalence, incidence and disease duration. Sensitivity analyses were performed to quantify the impact of alternative assumptions and model inputs. Results Global numbers of incident and prevalent cases of type 1 diabetes were estimated to be 234,710 and 9,004,610, respectively, in 2017. High-income countries, with 17% of the global population, accounted for 49% of global incident cases and 52% of prevalent cases. Asia, which has the largest proportion of the world’s population (60%), had the largest number of incident (32%) and prevalent (31%) cases of type 1 diabetes. Globally, 6%, 35%, 43% and 16% of prevalent cases were in the age groups 0–14, 15–39, 40–64 and 65+ years, respectively. Based on sensitivity analyses, the estimates could deviate by ±15%. Conclusions/interpretation Globally, type 1 diabetes represents about 2% of the estimated total cases of diabetes, ranging from less than 1% in certain Pacific countries to more than 15% in Northern European populations in 2017. This study provides information for the development of healthcare and policy approaches to manage type 1 diabetes. The estimates need further validation due to limitations and assumptions related to data availability and estimation methods. Graphical abstract

scholarly journals Association of type 1 diabetes and concentrations of drinking water components in Newfoundland and Labrador, Canada

2018 ◽  
Vol 6 (1) ◽  
pp. e000466 ◽  
Author(s):  
Roger Chafe ◽  
Rana Aslanov ◽  
Atanu Sarkar ◽  
Peter Gregory ◽  
Alex Comeau ◽  
...  
Keyword(s):  
Water Quality ◽  
Type 1 Diabetes ◽  
Drinking Water ◽  
Newfoundland And Labrador ◽  
Regional Analysis ◽  
Incidence Rates ◽  
Community Based ◽  
Design And Methods ◽  
Incident Cases

ObjectiveTo determine the association between drinking water quality and rates of type 1 diabetes in the Newfoundland and Labrador (NL) population, which has one of the highest incidences of type 1 diabetes reported globally.Research design and methodsThe study used a community-based, case-control design. We first calculated incidence rates of type 1 diabetes at the provincial, regional and community levels. The connection between incidence rates and components in public water supplies were then analyzed in three ways: to evaluate differences in water quality between communities with and without incident cases of type 1 diabetes, and to analyze the relationship between water quality and incidence rates of type 1 diabetes at both the community and regional levels.ResultsThe provincial incidence of type 1 diabetes was 51.7/100 000 (0-14 year age group) for the period studied. In the community-based analysis, there were significant associations found between higher concentrations of arsenic (β=0.268, P=0.013) and fluoride (β=0.202, P=0.005) in drinking water and higher incidence of type 1 diabetes. In the regional analysis, barium (β=−0.478, P=0.009) and nickel (β=−0.354, P=0.050) concentrations were negatively associated with incidence of type 1 diabetes.ConclusionsWe confirmed the high incidence of type 1 diabetes in NL. We also found that concentrations of some components in drinking water were associated with higher incidence of type 1 diabetes, but no component was found to have a significant association across the three different levels of analysis performed.

Decreased Incidence of Type 1 Diabetes in Young Finnish Children

2020 ◽  
Author(s):  
Anna Parviainen ◽  
Anna But ◽  
Heli Siljander ◽  
Mikael Knip ◽  
the Finnish Pediatric Diabetes Register
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Age Groups ◽  
Incidence Rates ◽  
Islet Autoimmunity ◽  
Disease Rate ◽  
Age Group ◽  
Group A ◽  
Design And Methods

OBJECTIVE <p>The incidence of type 1 diabetes has been rising for decades, particularly among young children. Between 2006 and 2011 the incidence rate reached a plateau in Finland. In this observational register-based cohort study, we assess recent trends in the disease rate in Finnish children.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Based on data from the Finnish Pediatric Diabetes Register, we studied the incidence of type 1 diabetes among children under the age of 15 years between 2003 and 2018. We assessed sex-specific incidence rates (IRs) per 100,000 person years (PY) by 4-year time periods in three age groups (0.50–4.99, 5.00–9.99, and 10.00–14.99 years).</p> <p>RESULTS</p> <p>Among the 7,871 children with newly diagnosed type 1 diabetes, the median age at diagnosis increased from 7.88 to 8.33 (<i>P </i>= 0.001), while the overall IR decreased from 57.9/100,000 PY in 2003–2006 to 52.2/100,000 PY in 2015–2018, yielding an IR ratio (IRR) of 0.90 (95% CI 0.85–0.96, <i>P </i>= 0.001). This decline was mainly due to the decrease in the youngest age group [IRR 0.77 (95% CI 0.68–0.87); <i>P </i>< 0.001], being significant both among males and females. In the middle age group, a significant decrease was observed only among females. No changes were observed in the oldest children.</p> <p>CONCLUSIONS</p> <p>The incidence of type 1 diabetes decreased among young Finnish children between 2003 and 2018. Current findings imply that environmental factors driving the immune system towards islet autoimmunity are changing in young children.</p>

scholarly journals Methanolic extract of Origanum vulgare ameliorates type 1 diabetes through antioxidant, anti-inflammatory and anti-apoptotic activity

2015 ◽  
Vol 113 (5) ◽  
pp. 770-782 ◽  
Author(s):  
Milica Vujicic ◽  
Ivana Nikolic ◽  
Vassiliki G. Kontogianni ◽  
Tamara Saksida ◽  
Pantelis Charisiadis ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Incidence ◽  
Inflammatory Disorder ◽  
T Helper ◽  
Origanum Vulgare ◽  
Anti Inflammatory ◽  
The Impact ◽  
Diabetes Induction

Type 1 diabetes (T1D), an autoimmune inflammatory disorder, develops as a consequence of pancreatic β-cell destruction and results in hyperglycaemia. Since current T1D therapy mainly involves insulin replacement, the aim of the present study was to evaluate the therapeutic potential of Origanum vulgare L. ssp. hirtum (Greek oregano) leaf extract rich in biophenols for the treatment of T1D. The phytochemical profile of methanolic oregano extract (MOE) and aqueous oregano extract (AOE) was determined by liquid chromatography/electrospray ion-trap tandem MS (LC/DAD/ESI-MSn), while their main compounds were quantified by HPLC with diode array detection. After establishing their potent in vitro antioxidant activity, the extracts were administered to C57BL/6 mice treated with multiple low doses of streptozotocin for diabetes induction. While prophylactic AOE therapy had no impact on diabetes induction, MOE reduced diabetes incidence and preserved normal insulin secretion. In addition, MOE scavenged reactive oxygen and nitrogen species and, therefore, alleviated the need for the up-regulation of antioxidant enzymes. MOE treatment specifically attenuated the pro-inflammatory response mediated by T helper 17 cells and enhanced anti-inflammatory T helper 2 and T regulatory cells through the impact on specific signalling pathways and transcription factors. Importantly, MOE preserved β-cells from in vitro apoptosis via blockade of caspase 3. Finally, rosmarinic acid, a predominant compound in MOE, exhibited only partial protection from diabetes induction. In conclusion, acting as an antioxidant, immunomodulator and in an anti-apoptotic manner, MOE protected mice from diabetes development. Seemingly, there is more than one compound responsible for the beneficial effect of MOE.

scholarly journals Quality of Life and Glycemic Control in Saudi Children with Type 1 Diabetes at Different Developmental Age Groups

2021 ◽  
Vol 14 ◽  
pp. 117955142199067
Author(s):  
Amir Babiker ◽  
Bothainah Al Aqeel ◽  
Sarah Marie ◽  
Hala Omer ◽  
Aban Bahabri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Age Groups ◽  
Proxy Reports ◽  
Developmental Age ◽  
The Impact ◽  
Domain Scores

Background: Children with type 1 diabetes (T1D) at different stages of development have age-specific needs, which can influence their perception of quality of life (QoL). In our study, we aimed to emphasize these age-specific needs and assess the perception of QoL in Saudi children with T1D, as well as their parents correlating QoL scores with children’s glycemic control. Methods: This is a cross-sectional study in which children with T1D and their parents from 2 tertiary institutes in Saudi Arabia have answered a standard diabetes-specific QoL questionnaire (PedsQL™ 3.0 diabetes module, translated in Arabic). We also reported glycated hemoglobin (HbA1c) results for these children within a month of completing the questionnaire. The QoL total aggregate and domain scores for self (children) and proxy (parents’) reports were compared and correlated with children’s HbA1c. Results: A sample was 288 self and proxy reports from 144 children with T1D of 3 age groups: 5 to 7 years (7%), 8 to 12 years (49%), and 13 to 18 years (44%), and their parents. QoL differed significantly between self and proxy reports in the total aggregate and domain scores ( P-values range from .02 to <.001). The impact on QoL was significantly higher in female patients ( P = .043). Insulin pump users had better HbA1c ( P = .007), and HbA1c level was worse in those who intended to fast at Ramadan ( P = .005). Conclusion: Children with T1D at different developmental age groups perceive QoL differently than their parents. Adjusting management as per age-specific challenges could potentially improve these children’s QoL and glycemic control.

scholarly journals The Role of Age and Excess Body Mass Index in Progression to Type 1 Diabetes in At-Risk Adults

2017 ◽  
Vol 102 (12) ◽  
pp. 4596-4603
Author(s):  
Christine T Ferrara ◽  
Susan M Geyer ◽  
Carmella Evans-Molina ◽  
Ingrid M Libman ◽  
Dorothy J Becker ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Type 1 Diabetes ◽  
Body Mass ◽  
Protective Factor ◽  
Diabetes Incidence ◽  
Increased Risk ◽  
Diabetes Progression ◽  
The Impact

Abstract Background Given the global rise in both type 1 diabetes incidence and obesity, the role of body mass index (BMI) on type 1 diabetes pathophysiology has gained great interest. Sustained excess BMI in pediatric participants of the TrialNet Pathway to Prevention (PTP) cohort increased risk for progression to type 1 diabetes, but the effects of age and obesity in adults remain largely unknown. Objective To determine the effect of age and sustained obesity on the risk for type 1 diabetes in adult participants in the TrialNet PTP cohort (i.e., nondiabetic autoantibody-positive relatives of patients with type 1 diabetes). Research Design and Methods Longitudinally accumulated BMI &gt;25 kg/m2 was calculated to generate a cumulative excess BMI (ceBMI) for each participant, with ceBMI values ≥0 kg/m2 and ≥5 kg/m2 representing sustained overweight or obese status, respectively. Recursive partitioning analysis yielded sex- and age-specific thresholds for ceBMI that confer the greatest risk for type 1 diabetes progression. Results In this cohort of 665 adults (age 20 to 50 years; median follow-up, 3.9 years), 49 participants developed type 1 diabetes. Age was an independent protective factor for type 1 diabetes progression (hazard ratio, 0.95; P = 0.008), with a threshold of &gt;35 years that reduced risk for type 1 diabetes. In men age &gt;35 years and women age &lt;35 years, sustained obesity (ceBMI ≥5 kg/m2) increased the risk for type 1 diabetes. Conclusions Age is an important factor for type 1 diabetes progression in adults and influences the impact of elevated BMI, indicating an interplay of excess weight, age, and sex in adult type 1 diabetes pathophysiology.

scholarly journals Decreased Incidence of Type 1 Diabetes in Young Finnish Children

2020 ◽  
Author(s):  
Anna Parviainen ◽  
Anna But ◽  
Heli Siljander ◽  
Mikael Knip ◽  
the Finnish Pediatric Diabetes Register
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Age Groups ◽  
Incidence Rates ◽  
Islet Autoimmunity ◽  
Disease Rate ◽  
Age Group ◽  
Group A ◽  
Design And Methods

OBJECTIVE <p>The incidence of type 1 diabetes has been rising for decades, particularly among young children. Between 2006 and 2011 the incidence rate reached a plateau in Finland. In this observational register-based cohort study, we assess recent trends in the disease rate in Finnish children.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>Based on data from the Finnish Pediatric Diabetes Register, we studied the incidence of type 1 diabetes among children under the age of 15 years between 2003 and 2018. We assessed sex-specific incidence rates (IRs) per 100,000 person years (PY) by 4-year time periods in three age groups (0.50–4.99, 5.00–9.99, and 10.00–14.99 years).</p> <p>RESULTS</p> <p>Among the 7,871 children with newly diagnosed type 1 diabetes, the median age at diagnosis increased from 7.88 to 8.33 (<i>P </i>= 0.001), while the overall IR decreased from 57.9/100,000 PY in 2003–2006 to 52.2/100,000 PY in 2015–2018, yielding an IR ratio (IRR) of 0.90 (95% CI 0.85–0.96, <i>P </i>= 0.001). This decline was mainly due to the decrease in the youngest age group [IRR 0.77 (95% CI 0.68–0.87); <i>P </i>< 0.001], being significant both among males and females. In the middle age group, a significant decrease was observed only among females. No changes were observed in the oldest children.</p> <p>CONCLUSIONS</p> <p>The incidence of type 1 diabetes decreased among young Finnish children between 2003 and 2018. Current findings imply that environmental factors driving the immune system towards islet autoimmunity are changing in young children.</p>

scholarly journals Estimates of drug treated diabetes incidence and prevalence using Australian administrative pharmaceutical data

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Shaun Francis Purkiss ◽  
Tessa Keegel ◽  
Hassan Vally ◽  
Dennis Wollersheim
Keyword(s):  
Census Data ◽  
Age Groups ◽  
National Health Survey ◽  
Incidence Rates ◽  
Community Survey ◽  
Older Age ◽  
Diabetes Prevalence ◽  
Diabetes Incidence ◽  
Prevalence Estimates ◽  
Incident Cases

IntroductionThe incidence and prevalence of diabetes within a population are important public health metrics. Pharmaceutical administrative data may offer a resource that can contribute to quantifying these measures using the recorded signals derived from the drugs used to treat people with diabetes. ObjectiveTo estimate the longitudinal incidence and prevalence of drug treated (DT) diabetes in Australia utilising an Australian Pharmaceutical Benefits Scheme (PBS) dataset and compare estimates with community survey data for all diabetes reported in the Australian National Health Survey (NHS). MethodsPersons with DT diabetes were identified within the PBS dataset using assigned Anatomic Therapeutic Chemical codes for `Drugs used in diabetes'. Prevalent persons with DT diabetes were determined by a single annual treatment, and incident cases from the earliest treatment with diabetes medications. Counts were aggregated by age group and utilised Australian national census data as a denominator to calculate diabetes disease frequencies for the period 2004--14. Comparison of PBS prevalence data was made with NHS surveys over equivalent years. ResultsThe age adjusted incidence of DT diabetes was 3.4/1000 in 2006 and increased to 3.8/1000 in 2011 and 5.1/1000 in 2014. Age adjusted prevalence of DT diabetes in Australia also rose from 26.7/1000 in 2006 to 32.1/1000 in 2011 and 42.1/1000 in 2014. DT diabetes prevalence estimates correlated with NHS estimates of self-reported diabetes prevalence across age groups and in 2014 was r = 0.987. However, PBS estimates of DT diabetes prevalence generally underestimated NHS values of self-reported diabetes in older age groups with mean percentage differences of -22% to -3%. In contrast, PBS data captured more younger persons with diabetes in comparison to NHS data. These differences were then used to adjust DT diabetes incidence rates to provide age specific estimates that could potentially reflect diabetes incidence estimates acquired by community survey. ConclusionsPBS data representing dispensed medications prescribed to persons with diabetes offers a perspective for the assessment of diabetes incidence and prevalence. PBS derived DT diabetes prevalence estimates correlate well with community survey estimates of self-reported diabetes, but underestimate NHS data in older age groups. Calibrated DT incidence estimates may potentially reflect community survey derived diabetes incidence estimates and may offer a method for longitudinal monitoring.

scholarly journals Type 1 Diabetes Mellitus: Issues, Challenges and Opportunities

2018 ◽  
pp. 290-297
Author(s):  
Chrysanthus Chukwuma SR
Keyword(s):  
Type 1 Diabetes ◽  
Complex Disease ◽  
Diabetes Incidence ◽  
Incidence Data ◽  
Gene Environment ◽  
Challenges And Opportunities ◽  
Broad Variation ◽  
Low Incidence ◽  
Incident Cases

Diabetes is one of the most intensively researched disorders presenting several metabolic alterations, but the basic biochemical aberrations or defects have not been clearly elucidated because the disorder is characteristically of autoimmune disposition. In addition, it is an intricately complex disease that exhibits disparate and distinct outlook and magnitude of pathology with grim susceptibility to gene-environment interactions. Early or invariable developments of deteriorating clinical alterations culminate in expansive socioeconomic costs. Adequate data regarding type 1 diabetes incidence have been from regions with a high or intermediate incidence, particularly in Europe and North America where numerous registries have since been established. There is a paucity of data from Africa Asia, the Caribbean, Central America and South America. The availability of veritable standardized type 1 diabetes incidence data from these low incidence regions is extremely crucial to establish that the presumed broad variation in incidence pertains, and that a low incidence in those regions is exact and not the resultant impact of underestimated incident cases.

scholarly journals The impact of central obesity on the risk of hospitalization or death due to heart failure in type 1 diabetes: a 16-year cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Erika B. Parente ◽  
Valma Harjutsalo ◽  
Carol Forsblom ◽  
Per-Henrik Groop ◽  
Keyword(s):  
Heart Failure ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Central Obesity ◽  
Cox Regression ◽  
General Obesity ◽  
Increased Risk ◽  
Incident Cases ◽  
The Impact

Abstract Background Obesity and type 2 diabetes are well-known risk factors for heart failure (HF). Although obesity has increased in type 1 diabetes, studies regarding HF in this population are scarce. Therefore, we investigated the impact of body fat distribution on the risk of HF hospitalization or death in adults with type 1 diabetes at different stages of diabetic nephropathy (DN). Methods From 5401 adults with type 1 diabetes in the Finnish Diabetic Nephropathy Study, 4668 were included in this analysis. The outcome was HF hospitalization or death identified from the Finnish Care Register for Health Care or the Causes of Death Register until the end of 2017. DN was based on urinary albumin excretion rate. A body mass index (BMI)  ≥  30 kg/m2 defined general obesity, whilst WHtR  ≥  0.5 central obesity. Multivariable Cox regression was used to explore the associations between central obesity, general obesity and the outcome. Then, subgroup analyses were performed by DN stages. Z statistic was used for ranking the association. Results During a median follow-up of 16.4 (IQR 12.4–18.5) years, 323 incident cases occurred. From 308 hospitalizations due to HF, 35 resulted in death. Further 15 deaths occurred without previous hospitalization. The WHtR showed a stronger association with the outcome [HR  1.51, 95% CI (1.26–1.81), z  =  4.40] than BMI [HR 1.05, 95% CI (1.01–1.08), z = 2.71]. HbA1c [HR 1.35, 95% CI (1.24–1.46), z = 7.19] was the most relevant modifiable risk factor for the outcome whereas WHtR was the third. Individuals with microalbuminuria but no central obesity had a similar risk of the outcome as those with normoalbuminuria. General obesity was associated with the outcome only at the macroalbuminuria stage. Conclusions Central obesity associates with an increased risk of heart failure hospitalization or death in adults with type 1 diabetes, and WHtR may be a clinically useful screening tool.

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