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 Trajectories of Childhood Adversity and Type 1 Diabetes: A Nationwide Study of One Million Children

2021 ◽  
Author(s):  
Jessica Bengtsson ◽  
Andreas Rieckmann ◽  
Bendix Carstensen ◽  
Jannet Svensson ◽  
Marit E. Jørgensen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age At Onset ◽  
Early Adulthood ◽  
Childhood Adversity ◽  
Incidence Rates ◽  
Material Deprivation ◽  
Childhood Adversities ◽  
Males And Females ◽  
Design And Methods

<b>Objective:</b> Experiencing adversities in childhood may increase the risk of type 1 diabetes through hyperactivation of the stress response system, but the empirical evidence is conflicting. We aim to describe the age-specific incidence of type 1 diabetes for males and females separately in five predefined groups covering the most common trajectories of adversity among Danish children. <p> </p> <p><b>Research Design and Methods:</b> We included all 1,081,993 children without parental type 1 diabetes born in Denmark from 1980–1998. We used register data to estimate age-specific incidence rates of type 1 diabetes in five trajectory groups of adversity characterized by 1) low adversity, 2) early life material deprivation, 3) persistent material deprivation, 4) loss or threat of loss in the family, and 5) cumulative high adversity. All analyses were stratified by sex.</p> <p><b> </b></p> <p><b>Results: </b>In total, 5619 persons developed type 1 diabetes before 2016. We found only minor differences when comparing the incidence rates of type 1 diabetes between the trajectory groups. The only clear exceptions were in the high vs. low adversity group, where males had a higher incidence of type 1 diabetes in childhood (<11 years [(IRR: 1.78; 95% CI: 1.31-2.42]) and females had a higher incidence in early adulthood (≥16 years [IRR: 2.19; 95% CI: 1.57-3.07]).</p> <p> </p> <p><b>Conclusions:</b> Childhood adversities were generally not associated with age-specific incidence of type 1 diabetes except among those exposed to a very high and increasing annual rate of childhood adversities. Differences between highly exposed males and females seem to depend on age at onset of type 1 diabetes.<b><br> </b></p>

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 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 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 Incidence and seasonality of type 1 diabetes: a population-based 3-year cohort study using the National Database in Japan

2020 ◽  
Vol 8 (1) ◽  
pp. e001262
Author(s):  
Yuichi Nishioka ◽  
Tatsuya Noda ◽  
Sadanori Okada ◽  
Tomoya Myojin ◽  
Shinichiro Kubo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Incidence Rate ◽  
Case Series ◽  
Population Based ◽  
Incidence Rates ◽  
The Self ◽  
National Database ◽  
Series Method ◽  
Design And Methods

IntroductionTo investigate the incidence of type 1 diabetes by age group (0–19, 20–39, 40–59, ≥60 years) in Japan and whether there is seasonality in this incidence.Research design and methodsThe incidence of type 1 diabetes from September 2014 to August 2017 was estimated using 2013–2018 data from the National Database of Health Insurance Claims and Specific Health Check-ups of Japan. The incidence rate was analyzed using Tango’s Index and the self-controlled case series method.ResultsOverall, 10 400 of the 79 175 553 included individuals were diagnosed with type 1 diabetes. The incidence of type 1 diabetes from September 2014 to August 2017 was 4.42/100 000 person-years. The incidence rates for men aged 0–19, 20–39, 40–59, and ≥60 years were 3.94, 5.57, 5.70, and 3.48, respectively. Among women, the incidence rates for the same age ranges were 5.22, 4.83, 4.99, and 3.31, respectively. Tango’s index showed that the incidence rate of type 1 diabetes was significantly associated with seasons among those aged 0–19 years. Further, the self-controlled case series method showed a significant interaction between age and season, with the incidence of type 1 diabetes being higher in spring for patients younger than 20 years of age.ConclusionsIn Japan, men aged 40–59 years and women aged 0–19 years are the groups with the highest incidence of type 1 diabetes. Further, the incidence of younger-onset diabetes in Japan was higher in spring (from March to May).

scholarly journals Trajectories of Childhood Adversity and Type 1 Diabetes: A Nationwide Study of One Million Children

2021 ◽  
Author(s):  
Jessica Bengtsson ◽  
Andreas Rieckmann ◽  
Bendix Carstensen ◽  
Jannet Svensson ◽  
Marit E. Jørgensen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age At Onset ◽  
Early Adulthood ◽  
Childhood Adversity ◽  
Incidence Rates ◽  
Material Deprivation ◽  
Childhood Adversities ◽  
Males And Females ◽  
Design And Methods

<b>Objective:</b> Experiencing adversities in childhood may increase the risk of type 1 diabetes through hyperactivation of the stress response system, but the empirical evidence is conflicting. We aim to describe the age-specific incidence of type 1 diabetes for males and females separately in five predefined groups covering the most common trajectories of adversity among Danish children. <p> </p> <p><b>Research Design and Methods:</b> We included all 1,081,993 children without parental type 1 diabetes born in Denmark from 1980–1998. We used register data to estimate age-specific incidence rates of type 1 diabetes in five trajectory groups of adversity characterized by 1) low adversity, 2) early life material deprivation, 3) persistent material deprivation, 4) loss or threat of loss in the family, and 5) cumulative high adversity. All analyses were stratified by sex.</p> <p><b> </b></p> <p><b>Results: </b>In total, 5619 persons developed type 1 diabetes before 2016. We found only minor differences when comparing the incidence rates of type 1 diabetes between the trajectory groups. The only clear exceptions were in the high vs. low adversity group, where males had a higher incidence of type 1 diabetes in childhood (<11 years [(IRR: 1.78; 95% CI: 1.31-2.42]) and females had a higher incidence in early adulthood (≥16 years [IRR: 2.19; 95% CI: 1.57-3.07]).</p> <p> </p> <p><b>Conclusions:</b> Childhood adversities were generally not associated with age-specific incidence of type 1 diabetes except among those exposed to a very high and increasing annual rate of childhood adversities. Differences between highly exposed males and females seem to depend on age at onset of type 1 diabetes.<b><br> </b></p>

A retrospective regional analysis of outcomes during transition of young people with type 1 diabetes

2018 ◽  
Author(s):  
Melanie Kershaw ◽  
Marie Atkins ◽  
Suzanne Digwood ◽  
Hilary McCoubrey ◽  
Marie McGee ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Regional Analysis

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

2020 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Hemoglobin A1c ◽  
Diabetes Technology ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship ◽  
Pediatric Type 1 Diabetes

<b>Objective:</b> As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. <p> </p> <p><b>Research Design and Methods: </b>Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. </p> <p> </p> <p><b>Results: </b>HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant.</p> <p> </p> <p><b>Conclusions: </b>Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry. </p>

Care of children with type 1 diabetes mellitus in school – An interventional study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Umamaheswari Gurunathan ◽  
Hemchand Krishna Prasad ◽  
Sherline White ◽  
Bala Prasanna ◽  
Thangavelu Sangaralingam
Keyword(s):  
Type 1 Diabetes ◽  
Education Program ◽  
School Teachers ◽  
Post Intervention ◽  
Community Based ◽  
Structured Education ◽  
Type 1 Dm ◽  
The Impact ◽  
Determining Factor

AbstractObjectivesPaucity of data from India on care of children with Type 1 diabetes in schools. Aims: To study assess the knowledge, attitude, practices and fear of Type 1 diabetes in school teachers and to assess the impact of an educational model on the fear of teachers and care of children in Type 1 DM at school hours.MethodsA community based study, involving school teachers and the intervention being educating them about diabetes conducted. Data pertaining to basic demography, attitude of teachers towards diabetic children, Hypoglycemia fear factor survey- parent version with worries domain and preparedness of school was collected. An education program was conducted on diabetes care in children. Immediately and after three months, the proforma details and HFSP-W scores reassessed.ResultsForty two teachers (mean age: 38.7±5.4; M:F ratio 2:40) participated in the study. Post intervention, a higher willingness to have the diabetic child in class (100 vs. 57.1%; p>0.05), better support in daily care (100 vs. 92%; p>0.05), participation in sports activities (100 vs. 7.1%; p<0.05) observed. HFSP-W scores were 38.8±4.5 (pre-intervention), 22.5±4.3 (immediate post intervention) and 29.5±3.2 (at 3months) (p<0.05). To study the determinants of improvement in HFSP-W a regression analysis was performed: presence of glucometer the most likely determining factor (T=1.999, p=0.05).ConclusionThere is a significant element of fear in the minds of teachers towards hypoglycemia which improves with a structured education program.

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