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Zhang C, Luo X. The increase in diabetes in children from underdeveloped countries. Curr Opin Pediatr 2024; 36:467-472. [PMID: 38832684 PMCID: PMC11224563 DOI: 10.1097/mop.0000000000001366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
PURPOSE OF REVIEW The incidence of type 1 diabetes (T1D) in children and adolescents has been increased over decades worldwide. Recent studies showed that the trend of T1D incidences were different between developed and underdeveloped countries. This review aimed to summarize the changes of childhood T1D incidences in underdeveloped countries over the past decade. RECENT FINDINGS Majority of the underdeveloped countries lacked of nationwide population-based studies on childhood T1D. We reviewed the trend of childhood T1D in important underdeveloped countries with available data in recent years. The incidences of childhood T1D in underdeveloped countries were low decades ago, but it increased significantly recently, particularly in the sub-Saharan African, Middle East and North African regions. SUMMARY The incidences of childhood T1D increased significantly in underdeveloped countries, especially in the sub-Saharan African, Middle East and North African regions. T1D registry and population-based studies are helpful to understand the situation and characteristic of childhood T1D in underdeveloped countries.
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Affiliation(s)
- Cai Zhang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Pediatric Genetic Metabolic and Endocrine Rare Diseases
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Pediatric Genetic Metabolic and Endocrine Rare Diseases
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Tampe I, Garfias C, Borzutzky A, Slaibe L, García H. Incidence of type 1 diabetes in Chilean children between 2006 and 2021: significant increase during the COVID-19 pandemic. Acta Diabetol 2024; 61:29-34. [PMID: 37578530 DOI: 10.1007/s00592-023-02163-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023]
Abstract
AIMS An increase in type 1 diabetes (T1D) incidence has been observed in several countries during the COVID-19 pandemic. The objective of this study is to determine T1D incidence trends in Chilean children between 2006 and 2021, and specifically evaluate the effect of the COVID-19 pandemic in this population. METHODS We reviewed mandatory notifications of T1D in Chile's public and private health system in youth < 20 years between 2006 and 2021, and compared COVID-19 pre-pandemic and pandemic incidence. RESULTS In Chile, 9472 new T1D cases in children were confirmed between 2006 and 2021. The mean annual T1D incidence in the entire period was 12.7/100,000 inhabitants, with an incidence of 11.7/100,000 between 2006 and 2019 vs. 20.2/100,000 during 2020-2021 (β = 0.691, [95%CI 0.479-0903], p < 0.001.) The highest incidence was observed in the 10-14 years age group, but a significant increasing incidence was observed in all age groups. The second year of the COVID-19 pandemic, 2021, had the highest incidence rate of the study period. While a 5% mean annual increase was observed between 2006 and 2019, in 2021 the T1D incidence jumped 28.5% compared with the two previous years. We found a higher T1D incidence in population with private insurance than public insurance (14.8 vs. 11.7/100.000, respectively, RR = 1.26 [95%CI 1.03-1.53], p < 0.027). CONCLUSIONS T1D incidence rates in Chilean youth doubled between 2006 and 2018, subsequently presenting a striking increase during the COVID-19 pandemic.
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Affiliation(s)
- Ingeborg Tampe
- Endocrinology Unit, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Garfias
- Pediatric Endocrinology Unit, Universidad de Los Andes, Santiago, Chile
- Pediatric Endocrinology Unit, Hospital de La Florida, Santiago, Chile
| | - Arturo Borzutzky
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Hernan García
- Endocrinology Unit, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Morla E, Ibrahim A, Ogle GD, James S, Maniam J, Almanzar R, Rosario C, Matos A, Ruiz L, Martinez P, Lopez J. Incidence of type 1 diabetes in children in Dominican Republic, 2010-2019: A national collaborative study. Pediatr Diabetes 2022; 23:976-981. [PMID: 35689539 DOI: 10.1111/pedi.13380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/06/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022] Open
Abstract
The Dominican Republic has no recent data on type 1 diabetes (T1D) incidence in children. Therefore, a study was undertaken to determine this in persons aged <15 years (y). Data were collected on all new T1D diagnoses between 2010-2019 from the four institutions caring for children with T1D. Diagnosis was made according to standard criteria. No secondary ascertainment source was available. The trend and the effect of age and sex of T1D incidence was analyzed using Poisson regression. A total of 1224 new cases of T1D were diagnosed <15 y; mean ± standard deviation (range) 122 ± 12 (96-135) cases per year. Age at T1D diagnosis was 8.8 ± 3.7 y, with a significant female preponderance (n = 708, 57.8%, p < 0.001). When examined per 5-y age group, cases were consistently highest in 10-14 y, and lowest in 0-4 y in all study years. Mean crude T1D annual incidence was 4.3 (95% CI 3.5-5.1) per 100,000 population. There was no significant difference between incidence across the country's three departments (regions): Southeast (4.4 [3.4-5.7]/100,000 population), North (4.1 [2.9-5.6]), and Southwest (3.9 [2.4-5.9]). Mean standardized annual incidence was 4.1 (4.1-4.2) per 100,000 population, with no significant trend of increase over the study period. The incidence of T1D in children aged <15 y is relatively low in Dominican Republic, but consistent with the limited data from other countries in the region. However, the incidence is eight times higher than the previous estimate during 1995-1999. Ongoing surveillance is warranted.
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Affiliation(s)
- Elbi Morla
- Sociedad Dominicana de Endocrinología Pediátrica, Santo Domingo, Dominican Republic
| | - Ammar Ibrahim
- Instituto Nacional de Diabetes, Endocrinología y Nutrición, Santo Domingo, Dominican Republic
| | - Graham D Ogle
- Life for a Child Program, Diabetes NSW & ACT, Glebe, New South Wales, Australia
| | - Steven James
- Life for a Child Program, Diabetes NSW & ACT, Glebe, New South Wales, Australia.,School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Petrie, Queensland, Australia
| | - Jayanthi Maniam
- Life for a Child Program, Diabetes NSW & ACT, Glebe, New South Wales, Australia
| | - Rosario Almanzar
- Hospital Infantil, Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - Carmen Rosario
- Hospital Infantil, Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - Angela Matos
- Hospital Infantil, Dr. Arturo Grullón, Santiago De Los Caballeros, Dominican Republic
| | - Lourdes Ruiz
- Hospital Infantil, Dr. Arturo Grullón, Santiago De Los Caballeros, Dominican Republic
| | - Patricia Martinez
- Hospital Infantil, Dr. Hugo Mendoza, Santo Domingo, Dominican Republic
| | - Jose Lopez
- Fundacion Educativa Aprendiendo a Vivir, Santo Domingo, Dominican Republic
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Ugarte F, Santapau D, Gallardo V, Garfias C, Yizmeyián A, Villanueva S, Sepúlveda C, Rocco J, Pasten C, Urquidi C, Cavada G, San Martin P, Cano F, Irarrázabal CE. Urinary Extracellular Vesicles as a Source of NGAL for Diabetic Kidney Disease Evaluation in Children and Adolescents With Type 1 Diabetes Mellitus. Front Endocrinol (Lausanne) 2021; 12:654269. [PMID: 35046888 PMCID: PMC8762324 DOI: 10.3389/fendo.2021.654269] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 11/15/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Tubular damage has a role in Diabetic Kidney Disease (DKD). We evaluated the early tubulointerstitial damage biomarkers in type-1 Diabetes Mellitus (T1DM) pediatric participants and studied the correlation with classical DKD parameters. METHODS Thirty-four T1DM and fifteen healthy participants were enrolled. Clinical and biochemical parameters [Glomerular filtration Rate (GFR), microalbuminuria (MAU), albumin/creatinine ratio (ACR), and glycated hemoglobin A1c (HbA1c)] were evaluated. Neutrophil gelatinase-associated lipocalin (NGAL), Hypoxia-inducible Factor-1α (HIF-1α), and Nuclear Factor of Activated T-cells-5 (NFAT5) levels were studied in the supernatant (S) and the exosome-like extracellular vesicles (E) fraction from urine samples. RESULTS In the T1DM, 12% had MAU >20 mg/L, 6% ACR >30 mg/g, and 88% had eGFR >140 ml/min/1.72 m2. NGAL in the S (NGAL-S) or E (NGAL-E) fraction was not detectable in the control. The NGAL-E was more frequent (p = 0.040) and higher (p = 0.002) than NGAL-S in T1DM. The T1DM participants with positive NGAL had higher age (p = 0.03), T1DM evolution (p = 0.03), and serum creatinine (p = 0.003) than negative NGAL. The NGAL-E correlated positively with tanner stage (p = 0.0036), the median levels of HbA1c before enrollment (p = 0.045) and was independent of ACR, MAU, and HbA1c at the enrollment. NFAT5 and HIF-1α levels were not detectable in T1DM or control. CONCLUSION Urinary exosome-like extracellular vesicles could be a new source of early detection of tubular injury biomarkers of DKD in T1DM patients.
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Affiliation(s)
- Francisca Ugarte
- Pediatric Endocrinology Unit, Pediatric Service, Clinica Universidad de los Andes, Santiago, Chile
- Departament of Pediatrics, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
- Pediatric Endocrinology and Diabetes Unit, Hospital Dr. Exequiel González Cortés, Santiago, Chile
| | - Daniela Santapau
- Centro de Medicina Regenerativa, Facultad de Medicina, Clinica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Vivian Gallardo
- Pediatric Endocrinology and Diabetes Unit, Hospital Dr. Exequiel González Cortés, Santiago, Chile
| | - Carolina Garfias
- Pediatric Endocrinology Unit, Pediatric Service, Clinica Universidad de los Andes, Santiago, Chile
| | - Anahí Yizmeyián
- Pediatric Endocrinology and Diabetes Unit, Hospital Dr. Exequiel González Cortés, Santiago, Chile
| | - Soledad Villanueva
- Pediatric Endocrinology and Diabetes Unit, Hospital Dr. Exequiel González Cortés, Santiago, Chile
| | - Carolina Sepúlveda
- Pediatric Endocrinology and Diabetes Unit, Hospital Dr. Exequiel González Cortés, Santiago, Chile
| | - Jocelyn Rocco
- Programa de Fisiología, Laboratorio de Fisiología Integrativa y Molecular, Centro de Investigación e Innovación Biomédica (CIIB), Universidad de los Andes, Santiago, Chile
| | - Consuelo Pasten
- Programa de Fisiología, Laboratorio de Fisiología Integrativa y Molecular, Centro de Investigación e Innovación Biomédica (CIIB), Universidad de los Andes, Santiago, Chile
- School of Medicine, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
| | - Cinthya Urquidi
- Department of Epidemiology and Health Studies, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
| | - Gabriel Cavada
- Department of Public Health, School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Pamela San Martin
- School of Medicine, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
| | - Francisco Cano
- Pediatric Nephrology Unit, Pediatric Service, Hospital Luis Calvo Mackennna, Santiago, Chile
| | - Carlos E. Irarrázabal
- Programa de Fisiología, Laboratorio de Fisiología Integrativa y Molecular, Centro de Investigación e Innovación Biomédica (CIIB), Universidad de los Andes, Santiago, Chile
- School of Medicine, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
- *Correspondence: Carlos E. Irarrázabal,
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