TREND OF TYPE 1 DIABETES MELLITUS IN BOYS AND GIRLS UNDER 14 YEARS OF AGE IN BELGRADE IN THE PERIOD FROM 1992 TO 2017: JOINPOINT REGRESSION ANALYSIS
Abstract
Introduction/Aim: Type 1 diabetes (DM1) is one of the most common chronic diseases of childhood and adolescence. The incidence of DM1 in children and adolescents has increased worldwide. The aim of this study was to analyze the trend of DM1 in boys and girls aged 0-14 years in Belgrade during period 1992-2017.
Methods: Data on the number of children with diabetes for the period 1992-2017 were obtained from two hospitals, the Institute for Mother and Child Dr Vukan Cupic and the University Children's Hospitals, as well as from the registers. Belgrade population figures are official data from the Statistical Office of The Republic of Serbia. Based on the data obtained, crude, standardized and age-specific incidence rates of DM1were calculated.
Results: In Belgrade in the period 1992-2017 the average standardized incidence rate (per 100,000) is 13.9 for boys and 12.3 for girls aged 0-14 years. In both sexes, the age-specific incidence rate of DM1 increases with age and is highest at the age of 10-14 years. In the observed period of 26 years, there was a significant average annual increase in the standardized incidence rate of DM1 of + 3.3% in boys and + 3.1% in girls. In boys, a significant average annual increase in the age-specific incidence rate of DM1 was at the age of 5 to 9 years (+ 5.1%), and in girls in the age group 0-4 years (+ 12.9%).
Conclusion: A further follow-up of DM1 in children aged 0-14 years is needed in order to identify risk factors that contribute to the development of this disease and to take adequate preventive measures, as well as to organize the health care.
References
International Diabetes Federation. IDF Diabetes Atlas 9th edition. International Diabetes Federation; 2019.
Ma RCW, Chan JN. Diabetes Incidence of childhood type 1 diabetes: a worrying trend. Nature reviews Endocrinology 2009; 5(10):529-530.
Soltész G, Patterson C, Dahlquist G. Global trends in childhood type 1 diabetes. In: Diabetes Atlas. chapter 2.1. 3rd ed. International Diabetes Federation; 2006. p. 153-90.
Patterson C, Dahlquist G, Gyürüs E, Green A, Soltész G, EURODIAB Study Group. Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 2009; 373:2027–2033.
Soltesz G, Patterson C, Dahlquist G. Diabetes in the Young: a Global Perspective. In: IDF Diabetes Atlas fourth edition; 2009.
Variation and trends in incidence of childhood diabetes in Europe. EURODIAB ACE Study Group. Lancet. 2000; 355:873–876.
WHO study group. Diabetes mellitus (Technical Report Series no. 727). Geneva: World Health Organization, 1985.
Segi M. Cancer mortality for selected sites in 24 countries (1950-57). Sendai, Japan: Department of Public Health, Tohoku University of Medicine; 1960.
Kim HJ, Fay MP, Feuer EJ, Midthune DN: Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000; 19:335–351.
Lerman PM. Fitting segmented regression models by grid search. Appl Stat 1980; 29:77-84.
Kim HJ, Fay MP, Yu B, Barrett MJ, Feuer EJ. Comparability of segmented line regression models. Biometrics 2004; 60:1005-1014.
Karvonen M, Vuk-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J. Incidence of childhood type 1 diabetes worldwide. Diabetes Care 2000, 23:1516-26.
Sipetic S, Maksimovic J, Vlajinac H, Ratkov I, Sajic S, Zdravkovic D, Sipetic Z. Rising incidence of Type 1 diabetes in Belgrade children aged 0-14 years in the period from 1982 to 2005. J Endocrinol Invest 2013; 36:307-312.
Rojnic Putarek N, Ille J, Spehar Uroic A, Skrabic V, Stipancic G, Krnic N et al. Incidence of type 1 diabetes mellitus in 0 to 14-yr-old children in Croatia – 2004 to 2012 study. Pediatr Diabetes. 2015;16(6):448-53.
Stene LC. Magnus P, Lie R, Søvik O, Joner G, The Norwegian Childhood Diabetes Study Group. Birth weight and childhood onset type 1 diabetes: population based cohort study. BMJ 2001; 322:889–892.
Wilkin TJ. The accelerator hypothesis: weight gain as the missing link between type i and type ii diabetes. Diabetologia 2001; 44:914–922.
Knai C, Suhrcke M, Lobstein T. Obesity in eastern Europe: an overview of its health and economic implications. Econ Hum Biol 2007; 5:392–408.
Weets I, De Leeuw IH, Du Caju MV, et al. The incidence of type 1 diabetes in the age group 0–39 years has not increased in Antwerp (Belgium) between 1989 and 2000: evidence for earlier disease manifestation. Diabetes Care 2002; 25:840–46.
Pundziute-Lyckå A, Dahlquist G, Nyström L, et al. The incidence of Type I diabetes has not increased but shifted to a younger age at diagnosis in the 0–34 years group in Sweden 1983–1998. Diabetologia 2002; 45:783–91.
Kyvik KO, Nystrom L, Gorus F, et al. The epidemiology of type 1 diabetes mellitus is not the same in young adults as in children. Diabetologia 2004; 47:377–84.
Todorović S, Milenković T, Mitrović K, Plavšić Lj, Panić- Zarić S, Vuković R. Visoka prevalencija dijabetesne ketoacidoze kod mladih sa novootkrivenim tipom 1 dijabetesa melitusa u Beogradu - desetogodišnje iskustvo tercijernog centra. Zdravstvena zaštita 2019; 48(4):7-14.