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Title: Epidemiology of type 1 diabetes in children below 15 years of age between 1987-2005 living in Cracow region

Abstract:

Type 1 diabetes mellitus is one of the most common chronic diseases in pediatrie population. Despite the significant progress made in recent years in research on aetiopathogenesis of the disease as well as the monitoring and treatment, it is still necessary to substitute insulin parenterally, use nutritional therapy and perform daily self-control. The aim of the treatment is to achieve HbA1c <6,5% and to maintain blood glucose level in children as close to normal as possible and thus to protect patients against acute and chronic complications of the disease. For many years, in Poland and around the world, studies on incidence of type 1 diabetes in children and adolescents have been conducted. The results of these studies revealed significant geographical differences in worldwide incidence and a temporal increase tendency in the incidence. The studies showed the lowest incidence of diabetes among children in Asia and Latin Arnerica and the highest among the residents of the Nordic countries, Canada and Sardinia. The aim of this study was to determine the incidence of type 1 diabetes in children and adolescents aged 0-14 years living in a geographically well-defined area i.e. the city and the county of Kraków during the period 1987-2005. and to assess the incidence depending on sex, age of children, and urban vs. rural residence. Another goal of this study was to estimate s ; patio-temporal clusters of cases and to investigate the seasonality of the disease between 2000 and 2005. The study was based on a registry of the patients as a part of EURODIAB ACE program, then within the project of Ministry of Health from 1998, and since 2001 as our own study. The study is prospective since 1987. During the 19 years of the study period, 435 children aged O to 14 years (226 boys, 209 girls) with newly diagnosed type 1 diabetes were identified. There were 90 (21 % ) children in the youngest group (0-4 years), 165 (38%) children aged 5-9 years and the oldest group aged 10-14 years was the largest and comprised 180 patients ( 41 %). Standardized incidence rates for type 1 diabetes ranged from 5.2 /l 00 000/year in 1987 to 20.5 /100000/year in 2005; since 1997, incidence rates have exceeded 10/100 000/year. The average incidence rate over 19 years was 9 .2 / l 00 000/year. The analysis of incidence rates in the age subgroups 0-4, 5-9 and 10-14 years showed that the lowest rates in the incidence were noted in children under 5 years - 6,69, for children 5-9 and 10-14 years the incidence rates were similar ( 10,63 and 10,52 respectively). Neither girls nor boys showed a significant predominance, the standardized inciclence rates were 9, 1 for girls and 9,4, for boys. The analysis of the incidence of diabetes, depending on the place of residence revealed that ; children living in the city of Krakow had a much higher incidence rate than children living in rural areas (11.4 vs. 6.60, p <0.0001). The analysis of the trend showed a significant increase in incidence of type I diabetes in children 0-14 years by 0.59/100 OOO per year (p = 0.000044). The highest increase of incidence by 0.89/100 000/year (p = 0.00002) was observed in children aged 5-9 years living in Krakow region and in girls 5-9 years of age living in the city ofKrakow - by 1.64/100 000/year (p=0.001). In the age group 0-4 years, the annual increase of incidence rate was slightly lower and amounted to 0.62/100 000/year (p = 0.000064). The increase of inciclence among adolescents between 10 and 14 years of age was not significant equaling 0.25 / 100 000/year (p = 0.167). The increasing tendency was three times higher in children living in the city of Krakow as compared to those living in villages, 0.92 / 100 OOO/ year (p = 0.001) vs. 0.28 / 100 OOO/ year (p = 0.0250). The analysis of the seasonality of diabetes demonstrated that the majority of new cases was diagnosed in winter, and lowest number in summer months (p = 0.0293). The observed since 1997 incidence rates exceeding 10/100 000/year place the city and the county of Krakow in the group of areas with a high risk of diabetes and prompt to undertake activities aiming at early detection of the disease, improving tre ; atments and future implernentation of effective primary prevention.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree grantor:

Wydział Lekarski

Promoter:

Starzyk, Jerzy

Date issued:

2010

Identifier:

oai:dl.cm-uj.krakow.pl:3394

Call number:

ZB-113630

Language:

pol

Access rights:

tylko w bibliotece

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Last modified:

Mar 11, 2022

In our library since:

Mar 4, 2013

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http://dl.cm-uj.krakow.pl:8080/publication/3394

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ZB-113630 Mar 11, 2022
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