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Trends in incidence of Type I diabetes in European populations. AUT: Austria; BGR: Bulgaria; DEU: East-Germany; EST: Estonia; FIN: Finland; FRA: France; HUN: Hungary; ICE: Iceland; ITA: Italy (Turin); LVA: Latvia; LTU: Lithuania; MAT: Malta; NOR: Norway; POLk: Poland (Krakow); POLr: Poland (Rzeszów); POLw: Poland (Wielkopolska); SVK: Slovakia; SWE: Sweden; UNKl (UK, Leicestershire); UNKo (Oxford); UNKp (Plymouth); UNKs (Scotland); UNKy (Yorkshire). The model fitted to the incidence data was a multiplicative regression model with logarithm of the age standardized incidence as dependent variable, thus the scale of the incidence is logarithmic when straight lines were used in drawing the regression lines
Source publication
Several reports on the incidence of Type I (insulin-dependent) diabetes mellitus have suggested that the incidence is increasing. The aim of this study was to find out whether the incidence is increasing globally or restricted to a selected populations only and to estimate the magnitude of the change in incidence.
During 1960 to 1996 37 studies in...
Context in source publication
Context 1
... global trend and the annual increase in the in- cidence of Type I diabetes were estimated from the age-standardized incidence rates using the log-linear regression ( Table 2). The p value of less than 0.05 for the two-sided test for a non-zero regression coeffi- cient was regarded as evidence for the trend. The global annual increase was 3.0 % (95 % CI 2.59; 3.33, p = 0.0001) during 1960 to 1996, showing a highly sig- nificant increasing trend. When the annual incidence rates were weighted with the number of cases in each individual study, the increase in incidence was 2.5 % (95 % CI 2.32; 2.66; p = 0.0001). The estimated population-wise regression lines illustrate well the in- creasing trends (Fig. 1, ...
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Citations
... The elevated type 1 diabetes incidence in Finnish children has not leveled off, but maintains an increasing trajectory. A study was conducted to determine whether type 1 diabetes incidence was increasing globally or merely restricted to a selected population and to estimate the extent of change in incidence (Onkamo et al., 1999). From 1960 to 1996, 37 studies in 27 countries were conducted. ...
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. Hyperglycaemia, glucosuria, polyuria, hunger, thirst, emaciation, ketonuria, acidosis and defect in insulin functionality accompanied in several instances with debilitating sequelae involve blood vessel wall degeneration and ophthalmologic problems. Early or invariable developments of these deteriorating changes 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 been established earlier or since the mid-1980s. There is a paucity of data from Africa Asia, the Caribbean, Central America and South America. The setting up and maintenance of population-based registries in very low-incidence areas such as the Caribbean, Central America, South America, Asia and Africa are expansively cumbersome. If the incidence is lower, then, the surveillance population tends to be larger in order to collate stable estimates for rates. 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.
... While T1DM can manifest at any age, it most commonly presents during childhood and adolescence. Epidemiological studies have documented an escalating incidence of T1DM worldwide, with an estimated annual increase of 3-5% in the pediatric population [2]. The rising prevalence of T1DM underscores the urgent need for effective management strategies to mitigate its impact on affected individuals and healthcare systems. ...
Low vitamin D levels are common in children and adolescents with type 1 diabetes. Although a link between vitamin D status and glycemic control is suggested, the direct association with poor control is unclear. This study assessed the prevalence of low vitamin D (deficiency and insufficiency) and its relationship with HbA1c in youth with type 1 diabetes. A cross-sectional study at Benghazi Medical Center, Libya, from June to September 2018 included 63 patients (33 females, 30 males), aged 6-18 years. Data on socio-demographics, HbA1c, and vitamin D levels were collected. Vitamin D levels were categorized as deficient (<10 ng/ml), insufficient (10-19 ng/ml), or sufficient (≥20 ng/ml). Glycemic control was classified as good (HbA1c ≤ 7.5%), fair (7.6%-8.5%), or poor (≥8.6%). Analysis using SPSS version 18 showed patients had a mean age of 12 years (±3.9), BMI of 19.18 kg/m² (±3.70), diabetes duration of 4.90 years (±3.03), average HbA1c of 10.10% (±2.5), and mean vitamin D level of 17.70 ng/ml (±10.8). Deficient vitamin D was found in 27% of patients, with 36.5% insufficient and 36.5% sufficient. A weak negative correlation (r=-0.112, p=0.38) was observed between 25-hydroxyvitamin D and HbA1c. Low vitamin D levels, including deficiency and insufficiency, were prevalent in youth with type 1 diabetes. However,
... The latter carries a significant risk of mortality and morbidity. Such broad variation in the clinical symptoms of T1DM may reflect a heterogeneity in the pathogenesis of the disease [29]. The rate of b-cell destruction is mirrored clinically by different preclinical duration, age of onset, and severity of the symptoms. ...
Background — Type 1 diabetes mellitus causes serious disease complication in children. Objectives- The main objective of this study was to assess the frequency and severity of diabetic complication in children ≤ 20 years of age from Punjab, Pakistan. Methods — The data of diabetic patients and their blood samples were collected from the diabetic registries at three districts of Punjab, Pakistan. Fasting plasma glucose, random plasma glucose, HbA1c, and GAD-65 autoantibodies were measured in sampled blood serum. The data on other clinical symptoms at the onset of disease were recorded as well. Results — Out of 310 patients, 54.2% were male, and their mean age at the onset of disease was 13.22 years. Among all patients, according to clinical indicators, high severity of the disease and serious complications were revealed. Conclusions — The diabetic complications were severe in all patients from three districts of Punjab, Pakistan, at and below the age of 20 years.
... The latter carries a significant risk of mortality and morbidity. Such broad variation in the clinical symptoms of T1DM may reflect a heterogeneity in the pathogenesis of the disease [29]. The rate of b-cell destruction is mirrored clinically by different preclinical duration, age of onset, and severity of the symptoms. ...
Background-Type 1 diabetes mellitus causes serious disease complication in children. Objectives-The main objective of this study was to assess the frequency and severity of diabetic complication in children ≤ 20 years of age from Punjab, Pakistan. Methods-The data of diabetic patients and their blood samples were collected from the diabetic registries at three districts of Punjab, Pakistan. Fasting plasma glucose, random plasma glucose, HbA1c, and GAD-65 autoantibodies were measured in sampled blood serum. The data on other clinical symptoms at the onset of disease were recorded as well. Results-Out of 310 patients, 54.2% were male, and their mean age at the onset of disease was 13.22 years. Among all patients, according to clinical indicators, high severity of the disease and serious complications were revealed. Conclusions-The diabetic complications were severe in all patients from three districts of Punjab, Pakistan, at and below the age of 20 years.
... Type 1 Diabetes mellitus is known to have a considerable impact on vulnerable minds of adolescent subjects and their parents. Furthermore poor quality of life and well-being may seriously disrupt glycaemic control and lead to neglect of oral 2,3 hygiene. Previous Studies have shown that oral health is considerably 4, poor in diabetic subjects. ...
Background: Poor emotional well-being among type 1 diabetes mellitus subjects may disrupt glycaemic control and neglect oral hygiene. Aim: To determine association between poor glycaemic control and Oral Hygiene status with emotional well-being in T1DM adolescents. Methods and Material: A cross sectional study was conducted among 107 Type 1 diabetic adolescents. Emotional Wellbeing domains were assessed using WHO-5 Well-Being Index; Oral hygiene status was recorded using Oral Hygiene Index Simplified and Glycaemic control was determined using haemoglobin A1c test. Results: A significant association was noted with poor emotional well-being and elevated level of HbA1c and poor oral hygiene status. Conclusion: Children with recent diagnosis of type 1 diabetes mellitus, older age of onset, elevated HbA1c were identified to have higher prevalence of current poor emotional wellbeing. These children should be prioritized for behavioural and cognitive counselling.
... Increasing incidence and improvement in management of type 1 diabetes have led to a growing population of people >60 years of age living with this disease (1)(2)(3). Although all older adults are at increased risk for age-related cognitive decline, mild cognitive impairment (MCI), and dementia, those with type 1 diabetes have additional risk, with a recent study reporting neuropsychologically defined cognitive impairment in nearly half of those >60 years of age (4). ...
Objective
Older adults with type 1 diabetes are at high risk for cognitive impairment, yet the usefulness of common cognitive screening instruments has not been evaluated in this population.
Methods
A total of 201 adults ≥60 years of age with type 1 diabetes completed a battery of neuropsychological measures and the Montreal Cognitive Assessment (MoCA). Receiver operating characteristic (ROC) curves and Youden indices were used to evaluate overall screening test performance and select an optimal MoCA cutoff score for detecting low cognitive performance, as defined as ≥2 neuropsychological test performances ≥1.5 SD below demographically corrected normative data.
Results
The ROC area under the curve (AUC) was 0.745 (P < 0.001). The publisher-recommended cutoff score of <26 resulted in sensitivity of 60.4% and specificity of 71.4%, whereas a cutoff score of <27 resulted in sensitivity of 75.0% and specificity of 61.0%. The Youden indices for these cutoff scores were 0.318 and 0.360, respectively. Minimally acceptable sensitivity (i.e., >0.80) was obtained when using a cutoff score of <28, whereas >0.80 specificity was obtained with a cutoff score of <25.
Conclusions
The MoCA has modest overall performance (AUC = 0.745) as a cognitive screening instrument in older adults with type 1 diabetes. The standard cutoff score of <26/30 may not adequately detect individuals with neuropsychological testing–defined abnormal cognition. The optimal MoCA cutoff score (based on Youden’s index) was <27/30. A score of <28 resulted in acceptable sensitivity but was accompanied by low specificity (42%). Future studies with a more diverse population are needed to confirm these findings.
... The number of type 1 diabetes (T1D) cases worldwide increased significantly since the 1950s and is still increasing by more than 3% per year in the early 21st century (1,2). T1D results from complete autoimmune destruction of insulin producing beta cells leading to absolute insulin deficiency and the need for therapy with insulin injections or continuous insulin infusion via insulin pumps, such as the insertion of a bio artificial pancreas (BAP), to overcome the malfunction of the pancreas (3,4). ...
Background
Islet xenotransplantation may be a therapeutic option in type 1 diabetes. Recent advances in generating genetically modified source pigs offer advantages as immune suppressants can potentially be eliminated after the transplantation. Therapy monitoring would greatly benefit from noninvasive methods for assessing the viability of transplanted islets. Peptide-based positron emission tomography (PET) targeting the glucagon-like peptide-1 receptor (GLP1R) expression on beta cells may offer a procedure that can directly be translated from an experimental setting to the clinic. The aim of this study was to establish the labeling of the GLP1R ligand [ ⁶⁸ Ga]Ga-exendin-4, to demonstrate the feasibility to image porcine islet xenografts in vivo , and to compare signal quality for three different transplantation sites in a mouse model.
Methods
Mice with engrafted neonatal porcine islet cell clusters (NPICCs) under the kidney capsule, into the inguinal fold, or the lower hindlimb muscle were studied. After reaching normoglycemia, the mice were injected with [ ⁶⁸ Ga]Ga-exendin-4 for PET data acquisition. Subsequent autoradiography (AR) was used for comparing ex vivo data with in vivo uptake.
Results
NPICCs in the lower right hindlimb muscle could be detected in vivo and in AR. Due to the high background in kidney and urinary bladder, islets could not be detected in the PET data at transplantation sites close to these organs, while AR showed a clear signal for the islets in the inguinal fold.
Conclusion
PET with [ ⁶⁸ Ga]Ga-exendin-4 detects islets transplanted in the hindlimb muscle tissue of mice, offering the potential of longitudinal monitoring of viable porcine islets. Other sites are not suitable for in vivo imaging owing to high activity accumulation of Exendin-4 in kidney and bladder.
... Type 1 diabetes mellitus (T1D) is characterized by autoimmune destruction of pancreatic β-cells with consequent absolute insulin deficiency and hyperglycemia. It affects more than one million children and adolescents worldwide, and the incidence is progressively rising [1,2]. Since the discovery of insulin, there has been a sharp decline in the acute complication-related mortality associated with T1D. ...
... Since the discovery of insulin, there has been a sharp decline in the acute complication-related mortality associated with T1D. Further, with the advent of newer form of insulin analogs having better pharmacokinetic and pharmacodynamic profile and development of newer technology in this field, patients with T1D are living longer and hence inadvertently are at an increased risk of long-term complications [2]. ...
... On the contrary, Pan and colleagues noted that the pooled differences in the lumbar spine BMD were not different between T1D subjects and controls [14]. Similarly, Leidig-Bruckner Lumber spine Z-score -1.5 ± 1.4 -0.9 ± 0.9 0.019 Left hip BMD (gm/cm 2 ) 0.780 ± 0.112 0.902 ± 0.108 0.000 Left hip Z-score -1.4 ± 0.9 -0.5 ± 0.8 0.000 et al. did not observe any difference in femoral neck BMD between T1D subjects and controls [15]. These were further reinforced by observation of Novak D and colleagues, who reported comparable femoral and lumbar spine areal BMD between T1D and control subjects [16]. ...
... The latest publication from the International Diabetes Federation (IDF) Atlas (10th Edition) shows that type 1 diabetes mellitus (T1DM) incidence has been increasing in recent decades in nearly all countries studied [1]. Other studies also have shown a rapid increase in the incidence of childhood T1DM in patients aged less than 15 years [2][3][4][5][6][7][8][9][10][11]. Furthermore, the EURO-DIAB study [12] and the DIAMOND project [5] have shown a significantly wide variation in the incidence of T1DM worldwide. ...
... However, the rate of increase in the incidence was highest for the youngest age group (0-4 years). This finding is consistent with those of other studies [11,24,[29][30][31][32]. A 1989-2003 European study also showed that the most rapid increases in T1DM incidence were observed in children less than 5 years of age [29]. ...
IntroductionChina has a low incidence of type 1 diabetes mellitus (T1DM); however, based on the large population, the absolute numbers are high. Our aim was to assess the incidence of childhood T1DM in Beijing during 2011–2020, predicted incidence for 2025–2035, and to determine the incidence of diabetic ketosis or diabetic ketoacidosis (DK/DKA) in this population.Methods
Data on patients aged less than 15 years of age with newly diagnosed T1DM between January 1, 2011 and December 31, 2020 was obtained from five tertiary hospitals in Beijing and retrospectively analyzed.ResultsIn all, 636 children aged less than 15 years were diagnosed with T1DM during 2011–2020. The incidence of T1DM was 3.11–5.46 per 100,000 per year, with an average increase of 5.10% per year. The age-specific incidence for ages 0–4 years, 5–9 years, and 10–14 years was 2.97, 4.69, and 4.68 per 100,000 per year, respectively. The highest average annual increase (7.07%) in incidence was for the youngest age group. DK or DKA was present at the time of diagnosis of T1DM in 84.6% of patients. The age-specific incidence of T1DM among children aged less than 15 years was predicted to be 7.32, 11.4, and 11.52 per 100,000 in 2035 for ages 0–4 years, 5–9 years, and 10–14 years, respectively.Conclusions
The was a gentle increase in the incidence of childhood T1DM during 2011–2020 in Beijing. This increase is expected to continue for the next 15 years.
... Diabetes is a chronic and degenerative disease with short-and long-term multi-functional complications and significant associated mortality and morbidity [1,2]. Autoimmune T1D is a metabolic disorder characterized by elevated blood glucose levels as a result of decreased insulin secretion. ...
Background
Bone marrow stem cells have been shown to be a promising therapeutic strategy for autoimmune diseases. This study aimed to assess the safety and efficacy of autologous hematopoietic stem cell (ABMSC) transplantation without immunoablation used to suppress the autoimmune reaction in 6 children with newly diagnosed autoimmune diabetes mellitus. We monitored the levels of islet cell antibodies (ICA), antibodies against islet antigen-related tyrosine phosphatase 2 (IA2), glutamic acid-decarboxylase (GAD) antibodies, and anti-insulin antibodies (AIA).
Material/Methods
Between 2018 and 2022, 6 children (age 6–10 years, average 8 years) recently diagnosed with type 1 diabetes mellitus with the presence of ICA, IA2, GAD, AIA and ketoacidosis, were treated with an ABMSC stimulated with Filgrastim, granulocyte colony-stimulating factor (G-CSF), 10 ug/kg/day for 4 days. Bone marrow was harvested on day 5, collected by puncture and identified as mononuclear cells >180×10⁶/kg, CD34+ >0.22%, and transplanted by intravenous (i.v.) infusion. Patients were monitored with ICA, IA2, GAD, AIA, C-peptide, blood glucose, and glycosylated hemoglobin A1c (HbA1C) 6 months after the procedure.
Results
At 6-month follow-up, we observed a negative value of the ICA, which was previously positive (P<0.001). The IA2 (p=0.037) and GAD (P=0.377) antibodies decreased slowly but were significantly lower. AIA remained high. A decrease in blood glucose and HbA1C levels was observed (P<0.001). No complications occurred during follow-up.
Conclusions
Autologous hematopoietic stem cell transplantation without immunoablation was safe and effective in significantly decreasing the production and effect of autoantibodies against ICA, GAD, and IA2, as well as decreasing blood sugar levels and HbA1c.
