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Type 1 Diabetes Gender Prevalence

Epidemiology, Presentation, And Diagnosis Of Type 1 Diabetes Mellitus In Children And Adolescents

Epidemiology, Presentation, And Diagnosis Of Type 1 Diabetes Mellitus In Children And Adolescents

INTRODUCTION Type 1 diabetes mellitus (T1DM), one of the most common chronic diseases in childhood, is caused by insulin deficiency following destruction of the insulin-producing pancreatic beta cells. It most commonly presents in childhood, but one-fourth of cases are diagnosed in adults. T1DM remains the most common form of diabetes in childhood, accounting for approximately two-thirds of new diagnoses of diabetes in patients ≤19 years of age in the United States, despite the increasing rate of type 2 diabetes [1-4]. The epidemiology, presentation, and diagnosis of T1DM in children and adolescents are presented here. The pathogenesis of T1DM and the management and complications of childhood T1DM are discussed separately. (See "Pathogenesis of type 1 diabetes mellitus" and "Management of type 1 diabetes mellitus in children and adolescents" and "Complications and screening in children and adolescents with type 1 diabetes mellitus".) The assessment and management of individuals presenting during infancy with hyperglycemia also are discussed separately. (See "Neonatal hyperglycemia".) EPIDEMIOLOGY The incidence of childhood type 1 diabetes (T1DM) varies based upon geography, age, gender, family history, and ethnicity. Geographical variation — The incidence of childhood T1DM varies worldwide [5,6]. In Europe and China, the risk appears to rise as the geographical latitude (distance from the equator) increases [7-9]. This North-South variation is not found in the United States, even after adjusting for racial and ethnic variation [10]. When people relocate from a region of low to high incidence, their risk of developing T1DM also increases, suggesting a causative role for environmental factor(s). However, wide variations in incidence occur between neighboring areas of Continue reading >>

Gender And Age Dependent Effect Of Type1 Diabetes On Obesity And Altered Body Composition In Young Adults

Gender And Age Dependent Effect Of Type1 Diabetes On Obesity And Altered Body Composition In Young Adults

Gender and Age Dependent effect of type1 diabetes on obesity and altered body composition in young adults Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Poland The aim of the study was to evaluate the influence of age and gender on the prevalence of overweight and obesity, body composition and fatty tissue distribution in young adults with type 1 diabetes. 197 patients with type 1 diabetes aged 2040 years participated in the study. The control group consisted of 138 healthy adults. Body weight, height, waist and hip circumferences were measured. Analysis of body mass composition was performed using the bioimpedance. Study groups were stratified into cohorts aged < 30 and 30+ years. Overweight and obesity were diagnosed in 35.5% and 13.2% of diabetic patients and in 26.1% and 7.3% of the control group, respectively (p=0.016). In the whole study group, advanced age (OR=1.10; p < 0.001) and diabetes mellitus (OR=2.25; p=0.001) predisposed patients to excess body weight. Women had a lower prevalence of overweight and obesity, but a trend toward excessive body mass was observed in diabetic females (OR=1.18; p=0.181). Diabetic females more often had abdominal obesity than control females (mean difference 19.2%; p=0.020). Higher total body fat mass was found in the diabetic group (p=0.037). Diabetic females had a higher amount of absolute (p<0.001) and relative body fat mass (p=0.002), fat free mass (p=0.007), relative arm (p=0.007), leg (0<0.001) and trunk (p-=0.006) fat mass than control females. Diabetic males showed only higher relative fat mass of the lower limbs compared to control males (p=0.018). Patients with type 1 diabetes develop overweight and obesity in early adulthood more frequently than the general population and a Continue reading >>

Chapter 1: Epidemiology Of Type 1 Diabetes

Chapter 1: Epidemiology Of Type 1 Diabetes

Go to: Introduction This chapter describes the epidemiology of type 1 diabetes mellitus (T1D) around the world and across the lifespan. Epidemiologic patterns of T1D by demographic, geographic, biologic, cultural and other factors in populations are presented to gain insight about the etiology, natural history, risks, and complications of T1D. Studies of the epidemiology of T1D in diverse populations are aimed at the identification of causal factors of the disease and its complications. The elucidation of the complex interaction between genetic and environmental factors leading to T1D should inform ongoing efforts to treat, prevent, and eventually cure T1D. T1D is a heterogeneous disorder characterized by destruction of pancreatic beta cells, culminating in absolute insulin deficiency. The majority of cases are attributable to an autoimmune-mediated destruction of beta cells (type 1a) while a small minority of cases results from an idiopathic destruction or failure of beta cells (type 1b). T1D accounts for 5–10% of the total cases of diabetes worldwide1. A second and more prevalent category, type 2 diabetes (T2D), is characterized by a combination of resistance to insulin action and inadequate compensatory insulin secretory response1. T1D has been historically, and continues to be, the most common type of diabetes in children and adolescents, although type 2 diabetes (T2D) is increasingly diagnosed in youth2,3. In this chapter, we will review the epidemiology of T1D in the following order: Incidence and Prevalence, Risk Factors, Clinical Course, Treatment and Management, and Complications. Other reviews of the Epidemiology of T1D have been published recently4 including a text on the epidemiology of diabetes in youth5. Additionally, some topics in this chapter will be Continue reading >>

Journal Of Comprehensive Pediatrics

Journal Of Comprehensive Pediatrics

1 Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran * Corresponding author: Forough Saki, Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: + 98-7116473096, E-mail: [email protected] Journal of Comprehensive Pediatrics: August 2016, 7 (3) ; e37703 Published Online: August 6, 2016 To Cite: Saki F. Prevalence of Metabolic Syndrome in Children With Type 1 Diabetes in South of Iran, J Compr Ped. 2016 ;7(3):e37703. doi: 10.17795/compreped-37703 . Objectives: The aim of this study was to investigate the prevalence of metabolic syndrome, in children with type one diabetes mellitus (T1DM) for the first time in a population in the Middle East, and assess the influence of type of insulin therapy, daily dosage of insulin, family history of type 2 diabetes, gender and level of HbA1c on the prevalence of metabolic syndrome. Methods: This cross-sectional study was conducted on children with T1DM aged < 20 years, and duration of T1DM >2 years during years 2013 to 2014. Waist circumference, blood pressure, height and weight of children with diabetes, for calculation of body mass index (BMI), were measured by one physician. Fasting blood glucose and lipids were also measured. According to the age-modified standards of the ATPIII, metabolic syndrome was defined. All data were analyzed using the SPSS 18 software. Results: In this study, 87 children with diabetes (48 females and 39 males) aged 12.38 4.2 were enrolled. Overall, 40.9% of our patients had hypertension, 55.2% had hypertriglyceridemia, 36.8% had low high-density lipoprotein (HDL) and 6.9% of patients had abdominal obesity. Furthermore, 29.9% of these children had metabolic syndrome, which did not have a Continue reading >>

Diabetes And Gender.

Diabetes And Gender.

Diabetes and Metabolism, Division of Medicine, University of Bristol, UK. It is often assumed that there is little or no sex bias within either Type I (insulin-dependent) or Type II (non-insulin-dependent) diabetes mellitus. This review considers evidence that sex effects of interest and importance are present in both forms of the disease. Type I diabetes is the only major organ-specific autoimmune disorder not to show a strong female bias. The overall sex ratio is roughly equal in children diagnosed under the age of 15 but while populations with the highest incidence all show male excess, the lowest risk populations studied, mostly of non-European origin, characteristically show a female bias. In contrast, male excess is a consistent finding in populations of European origin aged 15-40 years, with an approximate 3:2 male:female ratio. This ratio has remained constant in young adults over two or three generations in some populations. Further, fathers with Type I diabetes are more likely than affected mothers to transmit the condition to their offspring. Women of childbearing age are therefore less likely to develop Type I diabetes, and--should this occur--are less likely to transmit it to their offspring. Type II diabetes showed a pronounced female excess in the first half of the last century but is now equally prevalent among men and women in most populations, with some evidence of male preponderance in early middle age. Men seem more susceptible than women to the consequences of indolence and obesity, possibly due to differences in insulin sensitivity and regional fat deposition. Women are, however, more likely to transmit Type II diabetes to their offspring. Understanding these experiments of nature might suggest ways of influencing the early course of both forms of Continue reading >>

The Effect Of Type 1 Diabetes Mellitus On The Gender Difference In Coronary Artery Calcification - Sciencedirect

The Effect Of Type 1 Diabetes Mellitus On The Gender Difference In Coronary Artery Calcification - Sciencedirect

Volume 36, Issue 7 , December 2000, Pages 2160-2167 The effect of type 1 diabetes mellitus on the gender difference in coronary artery calcification Author links open overlay panel Helen MColhounMFPHM To examine whether the gender difference in coronary artery calcification, a measure of atherosclerotic plaque burden, is lost in type 1 diabetic patients, and whether abnormalities in established coronary heart disease risk factors explain this. Type 1 diabetes abolishes the gender difference in coronary heart disease mortality because it is associated with a greater elevation of coronary disease risk in women than men. The pathophysiological basis of this is not understood. Coronary artery calcification and coronary risk factors were compared in 199 type 1 diabetic patients and 201 nondiabetic participants of similar age (30 to 55 years) and gender (50% female) distribution. Only one subject had a history of coronary disease. Calcification was measured with electron beam computed tomography. In nondiabetic participants there was a large gender difference in calcification prevalence (men 54%, women 21%, odds ratio 4.5, p < 0.001), half of which was explained by established risk factors (odds ratio after adjustment = 2.2). Diabetes was associated with a greatly increased prevalence of calcification in women (47%), but not men (52%), so that the gender difference in calcification was lost (p = 0.002 for the greater effect of diabetes on calcification in women than men). On adjustment for risk factors, diabetes remained associated with a threefold higher odds ratio of calcification in women than men (p = 0.02). In type 1 diabetes coronary artery calcification is greatly increased in women and the gender difference in calcification is lost. Little of this is explained by kno Continue reading >>

Time Trends And Gender Differences In Incidence And Prevalence Of Type 1 Diabetes In Sweden.

Time Trends And Gender Differences In Incidence And Prevalence Of Type 1 Diabetes In Sweden.

There are different opinions on a possible sex bias in diabetes. In Sweden we have access to data since the 1930s, making it an ideal model. We aimed to study gender differences and time trends in the incidence and prevalence of type 1 diabetes in Sweden. We found 30 articles on incidence and 8 on prevalence (6 overlapping). Times series on incidence were found regarding children 015 years of age (with the Swedish Childhood Diabetes Registry, SCDR, since 1977), with up to 14,721 children with diabetes and with a high degree of ascertainment. Incidence time series were also found for subjects aged 1534 (Diabetes Incidence Study in Sweden, DISS, since 1983), with up to 7,369 subjects and with a lower degree of ascertainment compared to SCDR. Regarding age from 40 years and above fewer studies were found, and with a much lower number of subjects with type 1 diabetes. Diabetes incidence in children has had a relative increase of approximately 2% per year since 1938. Incidence rates in children 014 years of age show no gender differences, but in subjects aged 1539 years a male preponderance up to twofold is found. Figures for subjects 40 years or older are more uncertain, but show a fairly equal incidence among men and women. The male preponderance in type 1 diabetes from age 15 up to 4050 could be due to hormonal influence, with higher peripheral insulin resistance among men in young adults and younger middle age. ... In general, there is no consensus about gender distribution in DM. Wandell et al. [29] reported no gender difference in diabetic children from 0 to14 years of age but in subjects aged from 15 to 39 years males were more up to 2 folds than females. ... Continue reading >>

Incidence Of Type 1 And Type 2 Diabetes In Adults Aged 30–49 Years

Incidence Of Type 1 And Type 2 Diabetes In Adults Aged 30–49 Years

The population-based registry in the province of Turin, Italy Abstract OBJECTIVE—Incidence of type 1 diabetes is considered to be low in adults, but no study has been performed in Mediterranean countries. RESEARCH DESIGN AND METHODS—We extended the study base of the registry of the province of Turin, Italy, to subjects aged 30–49 years in the period 1999–2001 to estimate the incidences of type 1 and type 2 diabetes. Diagnosis of type 1 diabetes was based on permanent insulin treatment or a fasting C-peptide level ≤0.20 nmol/l or islet cell (ICA) or GAD (GADA) antibody positivities. RESULTS—We identified 1,135 case subjects with high completeness of ascertainment (99%), giving an incidence rate of 58.0 per 100,000 person-years (95% CI 54.7–61.5). The incidence of type 1 diabetes was 7.3 per 100,000 person-years (6.2–8.6), comparable with the rates in subjects aged 0–14 and 15–29 years (10.3 [9.5–11.2] and 6.8 [6.3–7.4]). Male subjects had a higher risk than female subjects for both type 1 (rate ratio [RR] 1.70 [95% CI 1.21–2.38]) and type 2 (2.10 [1.84–2.40]) diabetes. ICA and/or GADA positivities were found in 16% of the cohort. In logistic regression, variables independently associated with autoimmune diabetes were age 30–39 years (odds ratio [OR] 2.39 [95% CI 1.40–4.07]), fasting C-peptide <0.60 nmol/l (3.09 [1.74–5.5]), and BMI <26 kg/m2 (2.17 [1.22–3.85]). CONCLUSIONS—Risk of type 1 diabetes between age 30 and 49 years is similar to that found in the same area between age 15 and 29 years. Further studies are required to allow geographical comparisons of risks of both childhood and adulthood autoimmune diabetes, the latter being probably higher than previously believed. Epidemiological studies (1–7) have provided evidence that Continue reading >>

Gender Play – The Relationship Between Gender And Diabetes

Gender Play – The Relationship Between Gender And Diabetes

In a recently published study, it was revealed that while death rates fell for men between the years 1971 to 2000 with diabetes, the rates for women with diabetes did not fluctuate. Men with diabetes live 7.5 years less than other men who do not have diabetes. This number increases to 8.2 years among women who have diabetes to those who do not.1 However, in a very different study, researchers at the University of Glasgow revealed that men are biologically more susceptible to getting diagnosed with type 2 diabetes than women.2 What do these studies mean? How can a male or a female prevent themselves from being diagnosed with Type 2 diabetes? If you already have Type 2 diabetes, what can be learned from these studies in order to have a good diabetes management? Also, how does diabetes affect male versus female? In this article, we will look at some of the most prominent studies conducted in this area and ways of preventing/managing for an efficient diabetes management based on one’s gender. The earlier mentioned research from University of Glasgow indicates that men do not need to gain more weight than women to be diagnosed with Type 2 diabetes. This means that women have to gain considerable weight and fat, compared to males, in order to have fat deposits that are linked with diabetes. While women store most of their fat in the thigh and hip area, men tend to store their fat mostly in the waist and in their liver. The results of this research were drawn from 51, 920 men and 43, 173 women in Scotland. The BMI for a diagnosis in diabetes in men was 31.83 compared to 33.69 in women. We are now aware of several factors that are at play for the increase in chances of getting Type 2 diabetes: lifestyle age ethnicity body weight obesity socioeconomic status. This study confir Continue reading >>

International Textbook Of Diabetes Mellitus, 4th Ed., Excerpt #7: Epidemiology And Risk Factors For Type 1 Diabetes Mellitus Part 1 Of 5

International Textbook Of Diabetes Mellitus, 4th Ed., Excerpt #7: Epidemiology And Risk Factors For Type 1 Diabetes Mellitus Part 1 Of 5

Home / Conditions / Type 1 Diabetes / International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #7: Epidemiology and Risk Factors for Type 1 Diabetes Mellitus Part 1 of 5 International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #7: Epidemiology and Risk Factors for Type 1 Diabetes Mellitus Part 1 of 5 Type 1 diabetes (T1DM) is one of the most prevalent severe chronic diseases of childhood, affecting more than 170,000 children in the United States, an increase of 23% since 2001 [1]. In the US, more than 25,000 children are diagnosed annually with 1:200 children and 1:100 adults diagnosed with T1DM during the lifespan [2]. T1DM is the leading cause of end-stage renal disease, blindness, and amputation, and a major cause of cardiovascular disease and premature death in the general population. Annually, in the US, an estimated 70200 children die at the onset of diabetes [3] with 30% of children who develop diabetes presenting with ketoacidosis. For unknown reasons, the incidence of T1DM has been increasing progressively over the last half century by 35% per year [4]. In addition the percentage of children expressing the highest risk HLA genotype (DR3/4-DQ2/8) has dramatically decreased over the past 50 years [5], apparently reflecting increased disease penetrance of lower risk haplotypes. The high incidence, associated severe morbidity, mortality, and associated healthcare expenditures make T1DM a prime target for prevention. Population-based epidemiological studies as well as family studies and clinical trials have provided new insights into the pathogenesis and natural history of T1DM. Such studies are essential for appropriate diagnosis and for evidence-based programs of prevention and treatment. The prevalence of T1DM, that is the proportion of people in the p Continue reading >>

Gender-disparities In Adults With Type 1 Diabetes: More Than A Quality Of Care Issue. A Cross-sectional Observational Study From The Amd Annals Initiative

Gender-disparities In Adults With Type 1 Diabetes: More Than A Quality Of Care Issue. A Cross-sectional Observational Study From The Amd Annals Initiative

Click through the PLOS taxonomy to find articles in your field. For more information about PLOS Subject Areas, click here . Gender-Disparities in Adults with Type 1 Diabetes: More Than a Quality of Care Issue. A Cross-Sectional Observational Study from the AMD Annals Initiative Contributed equally to this work with: Valeria Manicardi, Giuseppina Russo, Angela Napoli, Elisabetta Torlone, Patrizia Li Volsi, Carlo Bruno Giorda, Nicoletta Musacchio, Antonio Nicolucci, Concetta Suraci, Giuseppe Lucisano, Maria Chiara Rossi Affiliation Department of Internal Medicine, Montecchio Hospital Local Health Authority of Reggio Emilia, Reggio Emilia, Italy Contributed equally to this work with: Valeria Manicardi, Giuseppina Russo, Angela Napoli, Elisabetta Torlone, Patrizia Li Volsi, Carlo Bruno Giorda, Nicoletta Musacchio, Antonio Nicolucci, Concetta Suraci, Giuseppe Lucisano, Maria Chiara Rossi Affiliation Department of clinical and experimental medicine, University of Messina, Messina, Italy Contributed equally to this work with: Valeria Manicardi, Giuseppina Russo, Angela Napoli, Elisabetta Torlone, Patrizia Li Volsi, Carlo Bruno Giorda, Nicoletta Musacchio, Antonio Nicolucci, Concetta Suraci, Giuseppe Lucisano, Maria Chiara Rossi Affiliation Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, S. Andrea Hospital, Sapienza University, Rome, Italy Contributed equally to this work with: Valeria Manicardi, Giuseppina Russo, Angela Napoli, Elisabetta Torlone, Patrizia Li Volsi, Carlo Bruno Giorda, Nicoletta Musacchio, Antonio Nicolucci, Concetta Suraci, Giuseppe Lucisano, Maria Chiara Rossi Affiliation Department of Internal Medicine, Endocrinology and Metabolism, S. Maria della Misericordia Hospital, Perugia, Italy Contributed equally to this work with Continue reading >>

Gender-specific Epidemiology Of Diabetes: A Representative Cross-sectional Study

Gender-specific Epidemiology Of Diabetes: A Representative Cross-sectional Study

International Journal for Equity in Health The North West Adelaide Health Study Team International Journal for Equity in HealthThe official journal of the International Society for Equity in Health20098:6 Grant et al; licensee BioMed Central Ltd.2009 Diabetes and its associated complications are part of a chronic disease global epidemic that presents a public health challenge. Epidemiologists examining health differences between men and women are being challenged to recognise the biological and social constructions behind the terms 'sex' and/or 'gender', together with social epidemiology principles and the life course approach. This paper examines the epidemiology of a population with diabetes from the north-west metropolitan region of South Australia. Data were used from a sub-population with diabetes (n = 263), from 4060 adults aged 18 years and over living in the north-west suburbs of Adelaide, South Australia. Eligible respondents were asked to participate in a telephone interview, a self-report questionnaire and a biomedical examination. Diabetes (undiagnosed and diagnosed) was determined using self-reported information and a fasting blood test administered to participants. Data were analysed using SPSS (Version 10.0) and EpiInfo (Version 6.0). Factors associated with diabetes for both men and women were being aged 40 years and over, and having a low gross annual household income, obesity and a family history of diabetes. In addition, being an ex-smoker and having low cholesterol levels were associated with diabetes among men. Among women, having a high waist-hip ratio, high blood pressure and reporting a previous cardiovascular event or mental health problem were associated with diabetes. The results found that men and women with diabetes face different challenge Continue reading >>

Time Trends And Gender Differences In Incidence And Prevalence Of Type 1 Diabetes In Sweden.

Time Trends And Gender Differences In Incidence And Prevalence Of Type 1 Diabetes In Sweden.

Time trends and gender differences in incidence and prevalence of type 1 diabetes in Sweden. Centre for Family Medicine, Karolinska Institutet, Huddinge, Sweden. [email protected] There are different opinions on a possible sex bias in diabetes. In Sweden we have access to data since the 1930s, making it an ideal model. We aimed to study gender differences and time trends in the incidence and prevalence of type 1 diabetes in Sweden. We found 31 articles on incidence and 8 on prevalence (6 overlapping). Times series on incidence were found regarding children 0-15 years of age (with the Swedish Childhood Diabetes Registry, SCDR, since 1977), with up to 14,721 children with diabetes and with a high degree of ascertainment. Incidence time series were also found for subjects aged 15-34 (Diabetes Incidence Study in Sweden, DISS, since 1983), with up to 7,369 subjects and with a lower degree of ascertainment compared to SCDR. Regarding age from 40 years and above fewer studies were found, and with a much lower number of subjects with type 1 diabetes. Diabetes incidence in children has had a relative increase of approximately 2% per year since 1938. Incidence rates in children 0-14 years of age show no gender differences, but in subjects aged 15-39 years a male preponderance up to twofold is found. Figures for subjects 40 years or older are more uncertain, but show a fairly equal incidence among men and women. The male preponderance in type 1 diabetes from age 15 up to 40-50 could be due to hormonal influence, with higher peripheral insulin resistance among men in young adults and younger middle age. Continue reading >>

Differences By Sex In The Prevalence Of Diabetes Mellitus, Impaired Fasting Glycaemia And Impaired Glucose Tolerance In Sub-saharan Africa: A Systematic Review And Meta-analysis

Differences By Sex In The Prevalence Of Diabetes Mellitus, Impaired Fasting Glycaemia And Impaired Glucose Tolerance In Sub-saharan Africa: A Systematic Review And Meta-analysis

Esayas Haregot Hilawe a, Hiroshi Yatsuya b, Leo Kawaguchi a & Atsuko Aoyama a a. Department of Public Health and Health Systems, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. b. Fujita Health University School of Medicine, Toyoake, Japan. Correspondence to Esayas Haregot Hilawe (e-mail: [email protected]). Bulletin of the World Health Organization 2013;91:671-682D. doi: Introduction Increasing urbanization and the accompanying changes in lifestyle are leading to a burgeoning epidemic of chronic noncommunicable diseases in sub-Saharan Africa.1,2 At the same time, the prevalence of many acute communicable diseases is decreasing.1,2 In consequence, the inhabitants of sub-Saharan Africa are generally living longer and this increasing longevity will result in a rise in the future incidence of noncommunicable diseases in the region.1–3 Diabetes mellitus is one of the most prominent noncommunicable diseases that are undermining the health of the people in sub-Saharan Africa and placing additional burdens on health systems that are often already strained.4,5 In 2011, 14.7 million adults in the African Region of the World Health Organization (WHO) were estimated to be living with diabetes mellitus.6 Of all of WHO’s regions, the African Region is expected to have the largest proportional increase (90.5%) in the number of adult diabetics by 2030.6 Sex-related differences in lifestyle may lead to differences in the risk of developing diabetes mellitus and, in consequence, to differences in the prevalence of this condition in women and men.3 However, the relationship between a known risk factor for diabetes mellitus – such as obesity – and the development of symptomatic diabetes mellitus may not be simple. For example, in m Continue reading >>

Epidemiology Of Type 1 Diabetes

Epidemiology Of Type 1 Diabetes

Type 1 diabetes may present at any age, but most typically presents in early life with a peak around the time of puberty. Its incidence varies 50–100-fold around the world, with the highest rates in northern Europe and in individuals of European extraction. Both sexes are equally affected in childhood, but men are more commonly affected in early adult life. The distinction between type 1 and type 2 diabetes becomes blurred in later life, and the true lifetime incidence of the condition is therefore unknown. A variant form known as latent autoimmune diabetes in adults (LADA) has been described. The incidence of childhood type 1 diabetes is rising rapidly in all populations, especially in the under 5-year-old age group, with a doubling time of less than 20 years in Europe. The increasing incidence of type 1 diabetes suggests a major environmental contribution, but the role of specific factors such as viruses remains controversial. Incidence rates Type 1 diabetes has historically been most prevalent in populations of European origin, but is becoming more frequent in other ethnic groups. Within Europe the highest rates of childhood diabetes are found in Scandinavia and north-west Europe, with an incidence range from 57.4 cases/100,000 per year in Finland to 3.9/100,000 in Macedonia for children aged 0–14 years.[1] Genetically related populations may differ in incidence: for example, type 1 diabetes is more common in Norwegians than in Icelanders of largely Norwegian descent, while Finnish children have a threefold risk compared with Estonians.[2] The incidence of type 1 diabetes remains relatively low in populations of non-European descent around the world, but many of these now report a rising incidence of the disease. Kuwait, for example, now has an incidence of 22.3/ Continue reading >>

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