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Incidence rates for type 1 diabetes by age at diagnosis and sex, United States, 2001-2015 

Incidence rates for type 1 diabetes by age at diagnosis and sex, United States, 2001-2015 

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Background: While the United States has the largest number of children with type 1 diabetes mellitus, less is known regarding adult-onset disease. The present study utilizes nationwide data to compare the incidence of type 1 diabetes in youth (0-19 years) to that of adults (20-64 years). Methods: In this longitudinal study, the Clinformatics® Da...

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... 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. ...
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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.
... Data obtained from the Global Burden of Disease study described temporal trends in the incidence of different types of diabetes mellitus from 1990 to 2017 at global, regional and national levels [22], with a higher increase in estimated annual percentage change in type 2 diabetes compared with type 1 diabetes. Some studies have found an increase in type 1 diabetes in youth but not in adults [16,23]. The reason for the increase in type 1 diabetes incidence has, however, been less systematically studied as compared with type 2 diabetes. ...
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Diabetes is one of the most prevalent cardiometabolic disorders on the planet. Type 1 diabetes accounts for only a minority of all cases (recently estimated to be ~2% globally); however, since this is a disorder with an early onset, many people live with type 1 diabetes for a long time. CVD and premature death are the main long-term outcomes for both types of diabetes; however, the type of diabetes that carries the highest risk of these outcomes is a controversial topic and has not been widely studied. Because of the association between diabetes and CVD, the rise in type 2 diabetes prevalence over the past decades has huge effects on global health. The excess risk in people with diabetes compared with those without depends, to a large extent, on the presence of other factors, such as general cardiovascular risk factors (e.g. elevated LDL-cholesterol, hypertension and smoking) and also factors that are more specific to diabetes (e.g. HbA1c, and micro- and macroalbuminuria). Some contributory factors are modifiable, while others are not, such as age, sex and type of diabetes. Older people with type 2 diabetes who have risk factors that are under control can achieve levels of CVD risk that are similar to that of the general population, while younger individuals with type 1 diabetes are mostly unable to achieve similar levels of risk, probably because of long and cumulative exposure to raised blood glucose levels. Despite reports of declining rates of CVD among people with type 1 and type 2 diabetes, rising rates of both types of diabetes lead to a continuing rise in the number of people with cardiometabolic disorders worldwide, offsetting the progress made in many countries. Comparison between individuals with type 1 and type 2 diabetes with respect to risk of CVD is fraught with difficulties and highly dependent on other, concomitant factors, some of which are modifiable and others not. Nonetheless, as a whole, what matters most in determining the management of diabetes is absolute risk and lifetime risk. Life-long efforts to achieve glycaemic control, control of lipids and hypertension, and not smoking are key to prevention, with a healthy lifestyle and pharmacological therapy to be implemented as needed. Graphical abstract
... Se estima que la DM1 representa aproximadamente del 5 al 10% del total de casos de diabetes en el mundo 3 . El diagnóstico de la enfermedad se establece generalmente en una etapa temprana de la vida (antes de los 35 años) con dos principales picos de incidencia, el primero entre los 4 a 7 años y el segundo entre los 10 a 14 años 4,5 . El tratamiento y control de la DM1 es complejo, al requerirse el uso insulina de por vida, e implica involucrar diferentes intervenciones como el seguir un plan de alimentación, tener un automonitoreo de glucosa frecuente, realizar actividad física y llevar un seguimiento estrecho por parte de un equipo multidisciplinario de profesionales de la salud 6 . ...
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... Epidemiological studies from many parts of the world have shown that the incidence of T1DM is increasing by approximately 2-5% annually [6]. DKA occurs mostly in patients with T1DM and has a peak incidence in individuals aged between 10 and 14 years; however, its clinical manifestations can appear at almost any age [6,7]. The mean age of children with type 1 diabetic DKA was lower in our study, especially in the severe DKA group. ...
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Background Diabetic ketoacidosis (DKA) is one of the most severe acute complications of type 1 diabetes mellitus (T1DM). Patients with DKA of different severities may have different clinical manifestations, serum biochemical levels and hormone changes. Methods We retrospectively evaluated the clinical manifestations, serum hormone levels, and biochemical levels of 70 Chinese patients with moderate to severe type 1 DKA in the acute and recovery phases admitted to Shanghai Children’s Hospital from 2015 to 2020. Results The time required for acidosis correction in 37 patients with severe DKA was 5.9 h longer than that in 33 patients with moderate DKA ( P < 0.001). In addition, serum levels of serum ionized calcium ( P = 0.003), free triiodothyronine (FT3) ( P = 0.029), white blood cells (WBCs) ( P = 0.044), and triglycerides (TGs) ( P = 0.002) were significantly different between patients with moderate and severe DKA. Serum levels of ionized calcium decreased significantly after recovery from severe DKA. Within 1 week, thyroid hormone and blood lipid levels recovered to normal ranges without intervention. Conclusion Patients with severe DKA had higher acidosis correction times, higher WBC counts, TGs and ionized calcium levels, and lower FT3 levels than patients with moderate DKA. No additional intervention was required for thyroid hormone, and blood lipid and serum ionized calcium levels recovered to the normal range.
... [22], whereas, in a 14-year longitudinal study conducted in the United States, the highest incidence occurred in the 10-14 years (45.5/ 100,000 person-years) [23]. Interestingly, in the 0-4 years category, there appears to be less variability in incidence across world regions. ...
... Another study reported predominance in males by age ten and persisted throughout adulthood with the male to female incidence ratio of 1.32 (95% CI [1.30-1.35]) [23]. These sex differences may be explained with exposure to certain gendered behavioral practices and susceptibility to T1D environmental triggers or innate genetic predisposition and hormonal variance. ...
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... Globally, there is an increment in both incidence and prevalence, the overall annual incidence increment is about 2-3% [4]. The incidence of T1D differs by country and by within countries region; the diagnostic peak incidence is noticed in children at 10 -14 years old [5]. However; a considerable number of people are presented with T1D during adulthood [6]. ...
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... Puberty may be an accelerator for the onset of T1D and there is a peak in incidence during the peripubertal years. [16][17][18] There are gender differences in the age of onset of T1D, with younger age of onset in girls linked to their earlier start of puberty. The role of estrogen in modulating transcription of genes such as the IL-6 promoter, has been proposed to be one of the explanations for this variance. ...
... According to epidemiological data from high-risk areas U.S. and low-risk areas such as China, adult-onset T1DM is also more common than childhood-onset T1DM (3). Analysis of U.S. data from commercially insured individuals demonstrated the annual incidence rate of T1DM was 34.3 per 100,000 persons for ages 0-19 years and 18.6 per 100,000 persons for ages 20-64 years, but the total number of new cases in adults over a 14-year period was 19,174 compared with 13,302 in youth (4). Similarly, it has been reported that about 65.3% of the new onset T1DM cases occurred in adults as opposed to children in China (5). ...
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... In the past few decades, the worldwide incidence of T1DM has risen dramatically, particularly in children under 14 years old 31,40 . The estimated annual global number of newly diagnosed children rose by approximately 50% from 65,000 in 2003 (reF. ...
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... This result was expected, as the epidemiological data show that T1DM is more prevalent in women in Indonesia (60%) (20). Contrasting results were reported by Rogers et al. (21) in the UK, who found that the incidence of diabetes mellitus was higher in males than females, with a ratio of 1.32:1. The main reason for the epidemiological differences between sexes is still unknown. ...
Although mainly affected by the blood glucose levels, the level of HbA1c could be influenced by other important factors, such as an iron deficiency, which is commonly found in children with type 1 diabetes mellitus (T1DM). However, a clinical judgment could not be established, as previous studies still reported conflicting results and lack of data regarding Indonesia. We aimed to evaluate the correlation between the serum iron and HbA1c levels in children with T1DM. This single-center cross-sectional study was conducted from February to October 2020 at Sanglah Hospital, Bali, Indonesia. Patients aged 1–18 yr were included in this study. The HbA1c and serum iron levels were evaluated in the blood samples. Spearman and partial correlation analyses were used to analyze the correlations between variables. The statistical significance was set at P < 0.05. Thirty-three subjects were analyzed, with a mean age of 11.24 ± 3.76 yr. Low serum iron and poor glycemic index were found in 54.5% and 69.7% of the subjects, respectively. Spearman correlation analysis revealed a low negative correlation between the serum iron and HbA1c levels (Spearman’s rho = –0.376 P = 0.031). A partial correlation showed a moderate negative correlation (r = –0.473, P = 0.013) after adjusting for confounding variables. This study found a moderate negative correlation between the serum iron and HbA1c level in children and adolescents with T1DM.