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Stahl-Pehe A, Baechle C, Lanzinger S, Urschitz MS, Reinauer C, Kamrath C, Holl RW, Rosenbauer J. Trends in the incidence of type 1 diabetes and type 2 diabetes in children and adolescents in North Rhine-Westphalia, Germany, from 2002 to 2022. DIABETES & METABOLISM 2024; 50:101567. [PMID: 39095014 DOI: 10.1016/j.diabet.2024.101567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/02/2024] [Accepted: 07/09/2024] [Indexed: 08/04/2024]
Abstract
AIMS The objective of this study was to assess overall and segmented trends in the incidence of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in children and adolescents younger than 20 years, from 2002 to 2022. METHODS This study used registry data on physician-diagnosed T1DM or T2DM from primary and secondary sources, covering the German federal state of North Rhine-Westphalia with 18 million inhabitants. The ages at T1DM and T2DM onset ranged from 0 to 19 and 10-19 years, respectively. The main outcomes were direct age- and/or sex-standardized incidence rates per 100,000 person-years (PYs) and trends estimated as annual percentage changes (APCs), both with 95 % confidence intervals. The segmented trends for subperiods were based on joinpoint regression models. RESULTS From 2002-2022, 17,470 and 819 persons had incident T1DM and T2DM, respectively. The total number of PYs was 73,743,982 for T1DM and 39,210,453 for T2DM, with a mean coverage rate of 98 % for T1DM and 90 % for T2DM. The standardized T1DM incidence increased from 17.6 [16.3;18.9} in 2002 to 33.2 [31.3;35.1] in 2022, with an APC of 2.7 % [2.3 %;3.1 %]. The standardized T2DM incidence increased from 1.3 [0.8;1.7] in 2002 to 2.8 [2.0;3.6] in 2022, with an APC of 6.4 % [4.9 %;8.0 %]. There were four different segmented trends for T1DM and T2DM, with the incidence peaking in 2021 and subsequently declining. CONCLUSIONS The incidence rates of T1DM and T2DM have increased over the past 20 years, with a wave-like pattern during the Covid-19 pandemic.
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Affiliation(s)
- Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
| | - Christina Baechle
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Stefanie Lanzinger
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany; Institute of Epidemiology and Medical Biometry, CAQM, Ulm University, Ulm, Germany
| | - Michael S Urschitz
- German Paediatric Surveillance Unit, Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Christina Reinauer
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Clemens Kamrath
- Department of General Pediatrics, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, University of Freiburg, Freiburg, Germany
| | - Reinhard W Holl
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany; Institute of Epidemiology and Medical Biometry, CAQM, Ulm University, Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Calcaterra V, Tagi VM, De Santis R, Biuso A, Taranto S, D’Auria E, Zuccotti G. Endocrinological Involvement in Children and Adolescents Affected by COVID-19: A Narrative Review. J Clin Med 2023; 12:5248. [PMID: 37629291 PMCID: PMC10455095 DOI: 10.3390/jcm12165248] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Since the advent of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, an increased incidence of several endocrinological anomalies in acute-phase and/or long-term complications has been described. The aim of this review is to provide a broad overview of the available literature regarding changes in the worldwide epidemiology of endocrinological involvement in children since December 2019 and to report the evidence supporting its association with coronavirus disease 2019 (COVID-19). Although little is known regarding the involvement of endocrine organs during COVID-19 in children, the current evidence in adults and epidemiological studies on the pediatric population suggest the presence of a causal association between the virus and endocrinopathies. Untreated transient thyroid dysfunction, sick euthyroid syndrome, nonthyroidal illness syndrome, and hypothalamic-pituitary-adrenal (HPA) axis and central precocious puberty have been observed in children in acute infection and/or during multisystem inflammatory syndrome development. Furthermore, a higher frequency of ketoacidosis at onset in children with a new diagnosis of type 1 diabetes is reported in the literature. Although the direct association between COVID-19 and endocrinological involvement has not been confirmed yet, data on the development of different endocrinopathies in children, both during acute infection and as a result of its long-term complications, have been reported. This information is of primary importance to guide the management of patients with previous or current COVID-19.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (V.M.T.); (R.D.S.); (A.B.); (S.T.); (E.D.); (G.Z.)
| | - Veronica Maria Tagi
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (V.M.T.); (R.D.S.); (A.B.); (S.T.); (E.D.); (G.Z.)
| | - Raffaella De Santis
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (V.M.T.); (R.D.S.); (A.B.); (S.T.); (E.D.); (G.Z.)
| | - Andrea Biuso
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (V.M.T.); (R.D.S.); (A.B.); (S.T.); (E.D.); (G.Z.)
| | - Silvia Taranto
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (V.M.T.); (R.D.S.); (A.B.); (S.T.); (E.D.); (G.Z.)
| | - Enza D’Auria
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (V.M.T.); (R.D.S.); (A.B.); (S.T.); (E.D.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (V.M.T.); (R.D.S.); (A.B.); (S.T.); (E.D.); (G.Z.)
- Department of Biomedical and Clinical Sciences, University of Milan, 20122 Milan, Italy
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