Pattern, Trend and Predictors of Adult-Onset Type 1 Diabetes in Uyo, Nigeria

Background: Unlike what obtains in childhood-onset type 1 diabetes, there remains a paucity of data on adult-onset type 1 diabetes in Nigeria. Hence, the current study aimed to determine the general characteristics of adult-onset type 1 diabetes among subjects (aged ≥18 years) presenting at the University of Uyo Teaching Hospital (UUTH) in Akwa Ibom State, South-south Nigeria. Methods: A 5-year (2014–2018) retrospective records review of subjects with type 1 diabetes was undertaken, using hospital medical records retrieved from the Department of Health Information Management of UUTH. Diagnosed adult cases of type 1 diabetes were meticulously identified and the relevant data at the point of initial diagnosis were acquired on a specially designed data acquisition template. Results: A total of 47,357 medical cases were identified of which 362 adults were diagnosed with type I diabetes (mean age 33.12 ± 4.40, range 20–51 years) and the females (n = 204; 56.4%) predominated among those diagnosed. The overall, male gender, and female gender prevalence was 7.4/1,000 (95% confidence interval [CI]: 6.89–7.98), 3.3/1,000 (95% CI: 2.52–4.08), and 4.3/1,000 (95% CI: 3.61–4.99), respectively. The females exhibited the highest trough, peak, annual, and overall prevalence during the study period. The female gender (OR: 2.334; 95% CI: 1.407–3.478; p = 0.010), age ≤30 years (OR: 1.976; 95% CI: 0.875–3.211; p < 0.001), urban-dwelling (OR: 3.243; 95% CI: 2.3407.780; <0.001), diabetes family history (OR: 1.365; 95% CI: 0.678–2.010; p = 0.033), and the rainy season (OR: 1.129; 95% CI: 0.401–1.910; p < 0.001) were independent predictors among the overall adult type 1 diabetics. On gender-segregated analyses, age ≤30 years, urban-dwelling, diabetes family history, and the rainy season remained independent predictors among the male and female adult type 1 diabetics (p < 0.05). Conclusion: The study demonstrated a high burden of type 1 diabetes among adult residents of Uyo, Akwa Ibom State, South-South Nigeria. The predictors of adult type 1 diabetes, identified in the present study, are valuable epidemiologic evidence for the design of type 1 diabetes-targeted preventive programs by various concerned stakeholders.

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Type-2 Diabetes Family History Delays the Onset of Type-1 Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.87.7.8649 ◽

2002 ◽

Vol 87 (7) ◽

pp. 3192-3196 ◽

Cited By ~ 6

Author(s):

P. A. Zalloua ◽

H. Shbaklo ◽

G. Halaby ◽

H. Terwedow ◽

X. Xu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Family History ◽

Diabetes Family History ◽

Diabetes Family

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DR15-DQ6 remains dominantly protective against type 1 diabetes throughout the first five decades of life

Diabetologia ◽

10.1007/s00125-021-05513-4 ◽

2021 ◽

Author(s):

Nicholas J. Thomas ◽

John M. Dennis ◽

Seth A. Sharp ◽

Akaal Kaur ◽

Shivani Misra ◽

...

Keyword(s):

Type 1 Diabetes ◽

Major Type ◽

Diabetes Incidence ◽

Diabetes Diagnosis ◽

Risk Haplotype ◽

Adult Onset ◽

Uk Biobank ◽

Onset Type ◽

Increased Risk

Abstract Aims/hypothesis Among white European children developing type 1 diabetes, the otherwise common HLA haplotype DR15-DQ6 is rare, and highly protective. Adult-onset type 1 diabetes is now known to represent more overall cases than childhood onset, but it is not known whether DR15-DQ6 is protective in older-adult-onset type 1 diabetes. We sought to quantify DR15-DQ6 protection against type 1 diabetes as age of onset increased. Methods In two independent cohorts we assessed the proportion of type 1 diabetes cases presenting through the first 50 years of life with DR15-DQ6, compared with population controls. In the After Diabetes Diagnosis Research Support System-2 (ADDRESS-2) cohort (n = 1458) clinician-diagnosed type 1 diabetes was confirmed by positivity for one or more islet-specific autoantibodies. In UK Biobank (n = 2502), we estimated type 1 diabetes incidence rates relative to baseline HLA risk for each HLA group using Poisson regression. Analyses were restricted to white Europeans and were performed in three groups according to age at type 1 diabetes onset: 0–18 years, 19–30 years and 31–50 years. Results DR15-DQ6 was protective against type 1 diabetes through to age 50 years (OR < 1 for each age group, all p < 0.001). The following ORs for type 1 diabetes, relative to a neutral HLA genotype, were observed in ADDRESS-2: age 5–18 years OR 0.16 (95% CI 0.08, 0.31); age 19–30 years OR 0.10 (0.04, 0.23); and age 31–50 years OR 0.37 (0.21, 0.68). DR15-DQ6 also remained highly protective at all ages in UK Biobank. Without DR15-DQ6, the presence of major type 1 diabetes high-risk haplotype (either DR3-DQ2 or DR4-DQ8) was associated with increased risk of type 1 diabetes. Conclusions/interpretation HLA DR15-DQ6 confers dominant protection from type 1 diabetes across the first five decades of life. Graphical abstract

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