Screening and treatment of childhood type 1 and type 2 diabetes mellitus in Japan
Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan.Pediatric endocrinology reviews: PER 10/2012; 10 Suppl 1:51-61.
A large number of children with type 2 diabetes mellitus (T2DM) and a small number with a slowly progressive form of type 1 diabetes mellitus (SPT1DM) have been detected by a urine glucose screening program conducted at Japanese schools since 1974. The incidence of T2DM in children has increased over the last 3 decades and is estimated to be approximately 3.0/100,000/year, which is twice as that of T1DM. In contrast, SPT1DM in children is more prevalent in Asians, particularly Japanese, and exhibits unique clinical features that differ from those of the rapid onset form of T1DM, usually seen in Caucasians. In the first part of this review, we summarize the urine glucose screening program conducted at Japanese schools and clinical characteristics of the 2 diabetic subtypes in Japanese children. In recent years, concerns regarding childhood diabetes in Asian countries, including Japan, have risen, and medical care for the same is exceedingly developing. Intensive insulin therapy such as basal-bolus therapy by multiple daily insulin injections and pump therapy, both using insulin analogs, has been increasing in pediatric patients with T1DM. In addition, various antidiabetic medications have been introduced for children with T2DM. In the second part of this review, we describe treatment of Japanese children with T1DM and T2DM and changes in glycemic control as a result of development of the treatment.
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ABSTRACT: In the 2013 issue of the International Diabetes Federation (IDF) Diabetes Atlas, the prevalence of diabetes in the Western Pacific (WP) Region was reported to be 8.6% in 2013, or 138 million adults, and estimated to rise to 11.1%, or 201 million adults, in 2035. The prevalence estimates of impaired glucose tolerance in 2013 and 2035 were 6.8% and 9.0%, respectively. Over 50% of people with diabetes were undiagnosed. In 2013, 187 million deaths were attributable to diabetes, 44% of which occurred in the under the age of 60. The WP Region is home to one quarter of the world's population, and includes China with the largest number of people with diabetes as well as Pacific Islands countries with the highest prevalence rates. There is a rapid increase in diabetes prevalence in the young-to-middle aged adults, possibly driven by high rates of childhood obesity and gestational diabetes as well as rapid demographic and sociocultural transitions. Differences in genetics, ethnicity, cultures and socioeconomic development have led to complex host-environment-lifestyle interactions with marked disease heterogeneity, further influenced by access to care and treatment. Despite these challenges, the WP Region has provided notable examples to prevent and control diabetes.
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