Time trends in the incidence of type 1 diabetes in Finnish children: A cohort study

Diabetes Unit, Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland.
The Lancet (Impact Factor: 45.22). 05/2008; 371(9626):1777-82. DOI: 10.1016/S0140-6736(08)60765-5
Source: PubMed


Finland has the highest incidence of type 1 diabetes worldwide, reaching 40 per 100,000 people per year in the 1990s. Our aim was to assess the temporal trend in type 1 diabetes incidence since 2000 in Finnish children aged younger than 15 years and to predict the number of cases of type 1 diabetes in the future.
Children with newly diagnosed type 1 diabetes in Finland who were listed on the National Public Health Institute diabetes register, Central Drug Register, and Hospital Discharge Register in 1980-2005 were included in a cohort study. We excluded patients with type 2 diabetes and diabetes occurring secondary to other conditions, such as steroid use, Down's syndrome, and congenital malformations of pancreas.
10,737 children-5816 boys and 4921 girls-were diagnosed with type 1 diabetes before 15 years of age during 1980-2005. The average age-standardised incidence was 42.9 per 100,000 per year (95% CI 42.6-44.3) during this period, increasing from 31.4 per 100,000 per year in 1980 to 64.2 per 100,000 per year in 2005. The age-specific rates per 100,000 per year were 31.0, 50.5, and 50.6 at ages 0-4 years, 5-9 years, and 10-14-years, respectively. We noted a significant non-linear component to the time trend (p<0.0003). In children aged 0-4 years, the increase was largest, at 4.7% more affected every year. The overall boy-to-girl ratio of incidence was 1.1; at the age of 13 years, it was 1.7 (1.4-2.0). The predicted cumulative number of new cases with type 1 diabetes before 15 years of age between 2006 and 2020 was about 10 800.
The incidence of type 1 diabetes in Finnish children is increasing even faster than before. The number of new cases diagnosed at or before 14 years of age will double in the next 15 years and the age of onset will be younger (0-4 years).

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    • "Since the 11th century researchers have been trying to clarify the bonds between DM and male fertility, describing DM as " a collapse of sexual functions " . In the last few years, the deleterious effects of DM on male fertility have become a matter of continuous debate due to its rapidly increasing incidence and the fact that the first diagnosis is taking place in increasingly younger individuals (Harjutsalo et al., 2008; Lavizzo-Mourey, 2007). So, the notion that DM is usually an elderly's disease has been quickly disregarded. "
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    ABSTRACT: ndividuals with Diabetes Mellitus (DM) present marked reduction in sperm quality and higher DNA damage in spermatozoa, evidencing that this metabolic disorder impairs male fertility. These effects are related to defective testicular metabolic pathways and signaling, resulting in altered sperm metabolism. Spermatozoa metabolize several substrates to ensure energy supplies and any alteration in this feature compromises sperm quality. For ATP production, spermatozoa require substrate availability and the involvement of specific hexoses membrane carriers. DM is known to modulate the spermatozoa substrate consumption and/or production due to altered glycolytic behavior. In fact, glucose uptake and metabolism is highly deregulated in diabetic individuals. Herein, we present an overview of the implications of DM in sperm glucose uptake and metabolism. The understanding of these processes is essential to identify key mechanisms associated with DM-related male (in)fertility. Moreover, it may contribute to the development of therapeutics to counteract the dysfunction induced by DM in sperm metabolism.
    Molecular and Cellular Endocrinology 08/2014; DOI:10.1016/j.mce.2014.08.005 · 4.41 Impact Factor
    • "Type 1 diabetes mellitus (T1DM) is a T cell-mediated autoimmune disease characterized by excess inflammation, independent of adiposity and glycemic control. The incidence of T1DM diabetes is increasing at 3-5% per year worldwide,[456] and this increase cannot be accounted for by known genetic factors. It has been well known that both oxidative stress and inflammatory activity play crucial roles in the pathogenesis of T1DM. "
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    ABSTRACT: Objective: Melatonin is an indolamine hormone, synthesized from tryptophan in the pineal gland primarily. Melatonin exerts both antioxidative and immunoregulatory roles but little is known about melatonin secretion in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to measure serum melatonin levels in patients with T1DM and investigates their relationship with type 1 diabetes mellitus. Materials and Methods: Forty children and adolescents with T1DM (18 boys and 22 girls) and 30 healthy control subjects (17 boys and 13 girls) participated in the study. All patients followed in Pediatric Endocrinology and Metabolism Unit of Gaziantep University Faculty of Medicine and also control subjects had no hypertension, obesity, hyperlipidemia, anemia, and infection. Blood samples were collected during routine analysis, after overnight fasting. Serum melatonin levels were analyzed with ELISA. Results: There were no statistically significant differences related with age, sex, BMI distribution between diabetic group and control group. Mean diabetic duration was 2.89 ± 2.69 years. The variables were in the equation. Mean melatonin level in diabetic group was 6.75 ± 3.52 pg/ml and mean melatonin level in control group was 11.51 ± 4.74 pg/ml. Melatonin levels were significantly lower in diabetic group compared to controls (P < 0.01). Conclusions: Melatonin was associated with type 1 diabetes mellitus significantly. Because of the varied roles of melatonin in human metabolic rhythms, these results suggest a role of melatonin in maintaining normal rhythmicity. Melatonin may play role in preventing process of inflammation and oxidative stress.
    07/2014; 18(4):565-8. DOI:10.4103/2230-8210.137521
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    • "The current study included 99 children with newly diagnosed diabetes who were classified according to age into 3 age groups ((I): <2 years, (II): 2–<6 years and (III): 6–12 years) with higher incidence of disease in the older age group which is in accordance with several authors [11–14] while the younger age groups showed a rising incidence (45.5% in <6 years) which was in agreement with Harjutsalo et al. [15] and Patterson et al., [16], who expected in their studies doubling of the incidence of T1DM over the next 10 years. The EURODIAB reported a very wide range of incidence rates within Europe with the greatest increase in incidence rate among the young age groups [16]. "
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    ABSTRACT: Introduction and aim: Type-1-diabetes mellitus (T1DM) is the most commonly diagnosed type of DM in children and adolescents. We aim to identify the epidemiological profile, risk factors, clinical features, and factors related to delayed diagnosis or mismanagement in children with newly diagnosed T1DM in Taif, Saudi Arabia. Patients and methods: Ninety-nine newly diagnosed patients were included in the study along with 110 healthy controls. Patients were classified into 3 groups (I: >2 years, II: 2->6 years, and III: 6-12 years). Both patients and controls were tested for C-peptide, TSH, and autoantibodies associated with DM and those attacking the thyroid gland. Results: Diabetic ketoacidosis was present in 79.8%. Delayed and missed diagnoses were recorded in 45.5%, with significant correlation to age and district of origin. Severity at presentation showed significant correlation with age and cow's milk feeding. Group I, those with misdiagnosis or positive DM related autoantibodies, had more severe presentations. The correlation of C-peptide and TSH levels in patients and controls was significant for C-peptide and nonsignificant for TSH. Conclusion: Misdiagnosis and mismanagement are common and account for more severe presentation, especially in young children >2 years. Early introduction of cow's milk appears to be a risk factor for the development of T1DM.
    The Scientific World Journal 10/2013; 2013:421569. DOI:10.1155/2013/421569 · 1.73 Impact Factor
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