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Zhang FS, Li HJ, Yu X, Song YP, Ren YF, Qian XZ, Liu JL, Li WX, Huang YR, Gao K. Global trends and hotspots of type 2 diabetes in children and adolescents: A bibliometric study and visualization analysis. World J Diabetes 2025; 16:96032. [PMID: 39817223 PMCID: PMC11718446 DOI: 10.4239/wjd.v16.i1.96032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 09/30/2024] [Accepted: 11/19/2024] [Indexed: 11/29/2024] Open
Abstract
BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus (T2DM) among children and adolescents worldwide. Due to rapid disease progression, severe long-term cardiorenal complications, a lack of effective treatment strategies, and substantial socioeconomic burdens, it has become an urgent public health issue that requires management and resolution. Adolescent T2DM differs from adult T2DM. Despite a significant increase in our understanding of youth-onset T2DM over the past two decades, the related review and evidence-based content remain limited. AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes. METHODS This study utilized the terms "children", "adolescents", and "type 2 diabetes", retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection (SCI, SSCI, ESCI). Utilizing CiteSpace and VoSviewer software, we analyze and visually represent the annual output of literature, countries involved, and participating institutions. This allows us to predict trends in this research field. Our analysis encompasses co-cited authors, journal overlays, citation overlays, time-zone views, keyword analysis, and reference analysis, etc. RESULTS A total of 9210 articles were included, and the annual publication volume in this field showed a steady growth trend. The United States had the highest number of publications and the highest H-index. The United States also had the most research institutions and the strongest research capacity. The global hot journals were primarily diabetes professional journals but also included journals related to nutrition, endocrinology, and metabolism. Keyword analysis showed that research related to endothelial dysfunction, exposure risk, cardiac metabolic risk, changes in gut microbiota, the impact on comorbidities and outcomes, etc., were emerging keywords. They have maintained their popularity in this field, suggesting that these areas have garnered significant research interest in recent years. CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention, with genes, behaviors, environmental factors, and multisystemic interventions potentially emerging as future research hot spots.
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Affiliation(s)
- Fang-Shuo Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Hai-Jing Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xue Yu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yi-Ping Song
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yan-Feng Ren
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xuan-Zhu Qian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Jia-Li Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Wen-Xun Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yi-Ran Huang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Kuo Gao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
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Wang D, Hou X, Huang J, Sun J, Kadowaki T, Lee MK, Jenkins AJ, Ji L. Incidence and trends of type 1 diabetes before and after 2000 in the Western Pacific Region: A systematic review and meta-analysis. Diabetes Res Clin Pract 2024; 207:111055. [PMID: 38104899 DOI: 10.1016/j.diabres.2023.111055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/09/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To undertake a systematic review of publications describing Type 1 diabetes (T1DM) incidence, trends over time and associated factors in the Western Pacific Region (WPR). METHODS As per the PROSPERO-registered (CRD42019122646) protocol English (MEDLINE, Embase, Global Health) and Chinese data-bases (China National Knowledge Infrastructure, VIP, Wanfang) from onset to 31/12/2019 were searched for T1DM incidence in the WPR. Country level data extracted included annual crude incidence rates by sex, number of new cases per annum (p.a.) and cumulatively, and the population at-risk. A meta-analysis for T1DM incidence was performed (by region and narrow age-bands, where possible) with subgroup analyses by time and by region. FINDINGS Forty-five population-based studies (21 from China), published 1973-2017, estimated T1DM incidence, mostly in youth, in 11 WPR countries. After 2000, mean annual T1DM incidence/100,000 person years aged 0-14 years ranged from 0.9 (95 % confidence intervals (CI), 0.6-1.3) in Fiji to 23.2 (95 % CI, 21.3-25.2) in Australia. The mean annual increase over time ranged from 2.8 % in Australia (1990-2002) to 14.2 % in Shanghai (1997-2011). T1DM incidence increased most in China (2.7-fold over 30-years) then Thailand (2-fold over 15-years). Most studies documented increasing incidence with age, though only two studies included people aged ≥ 20 years. Many, but not all studies reported significantly higher T1DM incidence in females vs. males. CONCLUSION T1DM incidence in the WPR is generally increasing, varying by age, sex, time and country. Results increase understanding of regional T1DM incidence and inform research and healthcare strategies.
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Affiliation(s)
- Du Wang
- The George Institute for Global Health, People's Republic of China
| | - Xiaoli Hou
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Xinxiang Medical College, Xin Xiang 453100, People's Republic of China
| | - Juan Huang
- Department of Endocrinology and Metabolism, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, People's Republic of China
| | - Jianjing Sun
- Department of Endocrinology, Jining No.1 People's Hospital, Jining 272 011, Shandong, People's Republic of China
| | - Takashi Kadowaki
- Toranomon Hospital, The University of Tokyo, Minato-ku, Tokyo 105-8470, Japan
| | - Moon-Kyu Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | | | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No. 11, Xizhimen Nan Da Jie, Xicheng District, Beijing 100044, People's Republic of China.
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Tung JYL, Kwan EYW, But BWM, Wong WHS, Fu ACC, Pang G, Tsang JWY, Yau HC, Belaramani K, Wong LM, Wong SMY, Lo P, Ng KL, Yeung WKY, Chan KT, Chan AMK, Wong SWC, Tay MK, Chung J, Lee CY, Lam YY, Cheung PT. Incidence and clinical characteristics of pediatric-onset type 2 diabetes in Hong Kong: The Hong Kong childhood diabetes registry 2008 to 2017. Pediatr Diabetes 2022; 23:556-561. [PMID: 33978300 DOI: 10.1111/pedi.13231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/23/2021] [Accepted: 04/26/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE With increasing prevalence of childhood obesity worldwide, the incidence of pediatric-onset type 2 diabetes (T2D) is also increasing in many countries. We aim to analyze the time trend and incidence of T2D in children in Hong Kong from 2008 to 2017, and to characterize clinical characteristics at diagnosis. METHODS Data were retrieved from the Hong Kong Childhood Diabetes Registry. All children with T2D diagnosed at the age of less than 18 years from January 1, 2008 to December 31, 2017 and managed in the public health care system were included in this study. RESULTS In the incident years of 2008-2017 period, 391 children were diagnosed with T2D. The crude incidence rate was 3.42 per 100,000 persons/year [95% confidence interval (CI) 3.08-3.76], which was much higher than that in last registry of 1.27 per 100,000 persons/year in 1997-2007 (P < 0.001).Most children (76%) were asymptomatic and were diagnosed by routine screening. At presentation, a significant proportion presented with co-morbidities including fatty liver (37.9%), dyslipidaemia (35.3%), hypertension (22.5%), and microalbuminuria (12.8%). CONCLUSIONS The incidence of T2D in children has increased significantly in Hong Kong. Most of them were asymptomatic and picked up on routine health screening. Yet, comorbidities were commonly identified at diagnosis.
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Affiliation(s)
- Joanna Yuet-Ling Tung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.,Department of Paediatrics, Hong Kong Children's Hospital, Kowloon, Hong Kong
| | - Elaine Yin-Wah Kwan
- Department of Paediatrics, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong
| | - Betty Wai-Man But
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - Wilfred Hing-Sang Wong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | | | - Gloria Pang
- Department of Paediatrics, Hong Kong Children's Hospital, Kowloon, Hong Kong.,Department of Paediatrics, Princess Margaret Hospital, Kowloon, Hong Kong
| | | | - Ho-Chung Yau
- Department of Paediatrics, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Kiran Belaramani
- Department of Paediatrics, Hong Kong Children's Hospital, Kowloon, Hong Kong.,Department of Paediatrics, Tuen Mun Hospital, Hong Kong, Hong Kong
| | - Lap-Ming Wong
- Department of Paediatrics, Tuen Mun Hospital, Hong Kong, Hong Kong
| | | | - Priscilla Lo
- Department of Paediatrics, United Christian Hospital, Hong Kong, Hong Kong
| | - Kwok-Leung Ng
- Department of Paediatrics, United Christian Hospital, Hong Kong, Hong Kong
| | - Wilson Kwan-Yee Yeung
- Department of Paediatrics, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong
| | - Kwong-Tat Chan
- Department of Paediatrics, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong
| | - Angela Mo-Kit Chan
- Department of Paediatrics, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, Hong Kong
| | - Sammy Wai-Chun Wong
- Department of Paediatrics, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, Hong Kong
| | - Ming-Kut Tay
- Department of Paediatrics, Tseung Kwan O Hospital, Hong Kong, Hong Kong
| | - Jacky Chung
- Department of Paediatrics, Caritas Medical Centre, Hong Kong, Hong Kong
| | - Ching-Yin Lee
- Department of Paediatrics, Caritas Medical Centre, Hong Kong, Hong Kong
| | - Yuen-Yu Lam
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong, Hong Kong
| | - Pik-To Cheung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.,Paediatric Endocrinology, Genetic and Metabolism, Virtus Medical Group, Hong Kong, Hong Kong
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Tung JYL, Kwan EYW, But BWM, Wong WHS, Fu ACC, Pang G, Tsang JWY, Yau HC, Belaramani K, Wong LM, Wong SMY, Lo P, Ng KL, Yeung WKY, Chan KT, Chan AMK, Wong SWC, Tay MK, Chung J, Lee CY, Lam YY, Cheung PT. Increasing incidence of type 1 diabetes among Hong Kong children and adolescents: The Hong Kong Childhood Diabetes Registry 2008 to 2017. Pediatr Diabetes 2020; 21:713-719. [PMID: 32267057 DOI: 10.1111/pedi.13016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/09/2020] [Accepted: 03/29/2020] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The incidence of childhood-onset type 1 diabetes (T1D) has been reported to be rising but there is also evidence that it has been attenuated in recent years. We described the time trends and the incidence of T1D in children in Hong Kong from 2008 to 2017 and compared with the previous local registry in 1997 to 2007. METHODS Data were extracted from the Hong Kong Childhood Diabetes Registry, which was established in 2016. It consists of a retrospective registry (including all childhood diabetes diagnosed in 2008 to 2015) and a prospective registry (including all T1D children diagnosed from 2016 onwards). All T1D children diagnosed at the age of less than 18 years from 1 January 2008 to 31 December 2017 and managed in the public system were included in this study. RESULTS For the incident years in the 2008 to 2017 period, a total of 498 children with T1D was identified. The crude incidence rate was 4.3 per 100 000 person/year (95% confidence interval 3.96-4.72), which was much higher than the last registry of 2.2 per 100 000 persons/year. Using general linear model, the increment is statistically significant (P = .02). When compared to the last registry, the rate of increment had attenuated, with annual increment in crude incidence in the two periods for T1D <15 years changing from 4.3% to 3.5% (P = .02). CONCLUSIONS The incidence of T1D children increased significantly in the past two decades in Hong Kong, but the rate of increase had attenuated in recent years.
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Affiliation(s)
- Joanna Yuet-Ling Tung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Department of Paediatrics, Hong Kong Children's Hospital, Hong Kong, China
| | - Elaine Yin-Wai Kwan
- Department of Paediatrics, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Betty Wai-Man But
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, China
| | - Wilfred Hing-Sang Wong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Gloria Pang
- Department of Paediatrics, Princess Margaret Hospital, Hong Kong, China
| | | | - Ho-Chung Yau
- Department of Paediatrics, Prince of Wales Hospital, Hong Kong, China
| | | | - Lap-Ming Wong
- Department of Paediatrics, Tuen Mun Hospital, Hong Kong, China
| | | | - Priscilla Lo
- Department of Paediatrics, United Christian Hospital, Hong Kong, China
| | - Kwok-Leung Ng
- Department of Paediatrics, United Christian Hospital, Hong Kong, China
| | - Wilson Kwan-Yee Yeung
- Department of Paediatrics, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Kwong-Tat Chan
- Department of Paediatrics, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Angela Mo-Kit Chan
- Department of Paediatrics, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Sammy Wai-Chun Wong
- Department of Paediatrics, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Ming-Kut Tay
- Department of Paediatrics, Tseung Kwan O Hospital, Hong Kong, China
| | - Jacky Chung
- Department of Paediatrics, Caritas Medical Centre, Hong Kong, China
| | - Ching-Yin Lee
- Department of Paediatrics, Caritas Medical Centre, Hong Kong, China
| | - Yuen-Yu Lam
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong, China
| | - Pik-To Cheung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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5
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Magliano DJ, Sacre JW, Harding JL, Gregg EW, Zimmet PZ, Shaw JE. Young-onset type 2 diabetes mellitus - implications for morbidity and mortality. Nat Rev Endocrinol 2020; 16:321-331. [PMID: 32203408 DOI: 10.1038/s41574-020-0334-z] [Citation(s) in RCA: 254] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2020] [Indexed: 12/20/2022]
Abstract
Accumulating data suggest that type 2 diabetes mellitus (T2DM) in younger people (aged <40 years), referred to as young-onset T2DM, has a more rapid deterioration of β-cell function than is seen in later-onset T2DM. Furthermore, individuals with young-onset T2DM seem to have a higher risk of complications than those with type 1 diabetes mellitus. As the number of younger adults with T2DM increases, young-onset T2DM is predicted to become a more frequent feature of the broader diabetes mellitus population in both developing and developed nations, particularly in certain ethnicities. However, the magnitude of excess risk of premature death and incident complications remains incompletely understood; likewise, the potential reasons for this excess risk are unclear. Here, we review the evidence pertaining to young-onset T2DM and its current and future burden of disease in terms of incidence and prevalence in both developed and developing nations. In addition, we highlight the associations of young-onset T2DM with premature mortality and morbidity.
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Affiliation(s)
- Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
| | - Julian W Sacre
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jessica L Harding
- Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Edward W Gregg
- Faculty of Medicine, School of Public Health, Imperial College, London, UK
| | - Paul Z Zimmet
- Monash University, Department of Diabetes, Melbourne, Victoria, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
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6
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Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect 2020; 10:98-115. [PMID: 32296622 PMCID: PMC7146037 DOI: 10.34172/hpp.2020.18] [Citation(s) in RCA: 374] [Impact Index Per Article: 74.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 10/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Diabetes is referred to a group of diseases characterized by high glucose levels in blood. It is caused by a deficiency in the production or function of insulin or both, which can occur because of different reasons, resulting in protein and lipid metabolic disorders. The aim of this study was to systematically review the prevalence and incidence of type 1 diabetes in the world. Methods: A systematic search of resources was conducted to investigate the prevalence and incidence of type 1 diabetes in the world. The databases of Medline (via PubMed and Ovid),ProQuest, Scopus, and Web of Science from January 1980 to September 2019 were searched to locate English articles. The located articles were screened in multiple levels of title, abstract,and full-text and final studies that met the inclusion criteria were retrieved and included in the study. Results: From 1202 located articles, 193 studies were included in this systematic review. The results of meta-analysis showed that the incidence of type 1 diabetes was 15 per 100,000 people and the prevalence was 9.5% (95% CI: 0.07 to 0.12) in the world, which was statistically significant. Conclusion: According to the results, the incidence and prevalence of type 1 diabetes are increasing in the world. As a result, insulin will be difficult to access and afford, especially in underdeveloped and developing countries.
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Affiliation(s)
- Majid Mobasseri
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Shirmohammadi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tarlan Amiri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nafiseh Vahed
- Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Hosseini Fard
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
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7
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Luk AOY, Ke C, Lau ESH, Wu H, Goggins W, Ma RCW, Chow E, Kong APS, So WY, Chan JCN. Secular trends in incidence of type 1 and type 2 diabetes in Hong Kong: A retrospective cohort study. PLoS Med 2020; 17:e1003052. [PMID: 32078650 PMCID: PMC7032690 DOI: 10.1371/journal.pmed.1003052] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 01/22/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There is very limited data on the time trend of diabetes incidence in Asia. Using population-level data, we report the secular trend of the incidence of type 1 and type 2 diabetes in Hong Kong between 2002 and 2015. METHODS AND FINDINGS The Hong Kong Diabetes Surveillance Database hosts clinical information on people with diabetes receiving care under the Hong Kong Hospital Authority, a statutory body that governs all public hospitals and clinics. Sex-specific incidence rates were standardised to the age structure of the World Health Organization population. Joinpoint regression analysis was used to describe incidence trends. A total of 562,022 cases of incident diabetes (type 1 diabetes [n = 2,426]: mean age at diagnosis is 32.5 years, 48.4% men; type 2 diabetes [n = 559,596]: mean age at diagnosis is 61.8 years, 51.9% men) were included. Among people aged <20 years, incidence of both type 1 and type 2 diabetes increased. For type 1 diabetes, the incidence increased from 3.5 (95% CI 2.2-4.9) to 5.3 (95% CI 3.4-7.1) per 100,000 person-years (average annual percentage change [AAPC] 3.6% [95% CI 0.2-7.1], p < 0.05) in boys and from 4.3 (95% CI 2.7-5.8) to 6.4 (95% CI 4.3-8.4) per 100,000 person-years (AAPC 4.7% [95% CI 1.7-7.7], p < 0.05] in girls; for type 2 diabetes, the incidence increased from 4.6 (95% CI 3.2-6.0) to 7.5 (95% CI 5.5-9.6) per 100,000 person-years (AAPC 5.9% [95% CI 3.4-8.5], p < 0.05) in boys and from 5.9 (95% CI 4.3-7.6) to 8.5 (95% CI 6.2-10.8) per 100,000 person-years (AAPC 4.8% [95% CI 2.7-7.0], p < 0.05) in girls. In people aged 20 to <40 years, incidence of type 1 diabetes remained stable, but incidence of type 2 diabetes increased over time from 75.4 (95% CI 70.1-80.7) to 110.8 (95% CI 104.1-117.5) per 100,000 person-years (AAPC 4.2% [95% CI 3.1-5.3], p < 0.05) in men and from 45.0 (95% CI 41.4-48.6) to 62.1 (95% CI 57.8-66.3) per 100,000 person-years (AAPC 3.3% [95% CI 2.3-4.2], p < 0.05) in women. In people aged 40 to <60 years, incidence of type 2 diabetes increased until 2011/2012 and then flattened. In people aged ≥60 years, incidence was stable in men and declined in women after 2011. No trend was identified in the incidence of type 1 diabetes in people aged ≥20 years. The present study is limited by its reliance on electronic medical records for identification of people with diabetes, which may result in incomplete capture of diabetes cases. The differentiation of type 1 and type 2 diabetes was based on an algorithm subject to potential misclassification. CONCLUSIONS There was an increase in incidence of type 2 diabetes in people aged <40 years and stabilisation in people aged ≥40 years. Incidence of type 1 diabetes continued to climb in people aged <20 years but remained constant in other age groups.
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Affiliation(s)
- Andrea O. Y. Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
- Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
- * E-mail:
| | - Calvin Ke
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Eric S. H. Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - William Goggins
- School of Public Health, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Ronald C. W. Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
- Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
| | - Elaine Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Alice P. S. Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
- Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
| | - Wing-Yee So
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
- Hong Kong Hospital Authority, Hong Kong Special Administrative Region, People’s Republic of China
| | - Juliana C. N. Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People’s Republic of China
- Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
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8
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Chen YL, Huang YC, Qiao YC, Ling W, Pan YH, Geng LJ, Xiao JL, Zhang XX, Zhao HL. Climates on incidence of childhood type 1 diabetes mellitus in 72 countries. Sci Rep 2017; 7:12810. [PMID: 28993655 PMCID: PMC5634499 DOI: 10.1038/s41598-017-12954-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/12/2017] [Indexed: 12/25/2022] Open
Abstract
We are aimed to systematically assess the worldwide trend in incidence of childhood type 1 diabetes mellitus (CT1DM) from 1965 to 2012 and to discuss whether climate affect incidence of CT1DM. We searched the relevant literatures in detail to judge the effect of different climates on incidence of CT1DM. The climates included Mediterranean, monsoon, oceanic, continental, savanna, and rainforest. According to different climates, we further researched relevant factor such as sunshine durations and latitudes. The overall incidence of CT1DM in 72 countries was 11.43 (95% CI 10.31–12.55) per 100,000 children/yr. The incidence of CT1DM in Oceanic climate [10.56 (8.69–12.42)] is highest compared with other climates; the incidence in 40°–66°34′N/S [14.71 (12.30–17.29)] is higher than other latitude groups; the incidence in sunshine durations with 3–4 hours per day [15.17 (11.14–19.20)] is highest compared with other two groups; the incidence of CT1DM from 2000 to 2012 [19.58 (14.55–24.60)] is higher than other periods; all p < 0.01. Incidence of CT1DM was increasing from 1965 to 2012, but incidence in Oceanic climate is higher than other climates. Furthermore, it is higher in centers with higher latitude and lower sunshine durations. The climates might play a key role in inducing CT1DM.
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Affiliation(s)
- Yin-Ling Chen
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China.,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China
| | - Yong-Cheng Huang
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China
| | - Yong-Chao Qiao
- Department of Immunology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410078, China
| | - Wei Ling
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China
| | - Yan-Hong Pan
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China.,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China
| | - Li-Jun Geng
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China.,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China
| | - Jian-Long Xiao
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China.,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China
| | - Xiao-Xi Zhang
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China. .,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China.
| | - Hai-Lu Zhao
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China. .,Department of Immunology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410078, China. .,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China.
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Gong C, Meng X, Jiang Y, Wang X, Cui H, Chen X. Trends in childhood type 1 diabetes mellitus incidence in Beijing from 1995 to 2010: a retrospective multicenter study based on hospitalization data. Diabetes Technol Ther 2015; 17:159-65. [PMID: 25545069 DOI: 10.1089/dia.2014.0205] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The incidence of type 1 diabetes mellitus (T1DM) is increasing rapidly worldwide for children of every age group. MATERIALS AND METHODS A retrospective analysis of hospital registration data from five tertiary hospitals in Beijing, China, identified 485 patients (210 boys, 275 girls) younger than 15 years of age with newly diagnosed T1DM between 1995 and 2010. RESULTS From 1995 to 2010, the incidence of T1DM in patients <15 years of age ranged from 0.935-3.26 per 100,000 per year. During this period, the average age-standardized incidence rate was 1.7 per 100,000 per year, and the average annual increase in T1DM incidence was 4.36%. The highest rate increases occurred in boys and in patients <5 years of age. For both genders and all age groups, T1DM incidence increased at an accelerated rate after 2006. By 2020, the incidence of T1DM among children in Beijing is projected to increase by a factor of 1.69. CONCLUSIONS The incidence of T1DM among patients younger than 15 years of age in Beijing increased from 1995 to 2010, with rates growing at an accelerated pace since 2006. Based on recent trends, we project continued rapid growth in the number of new childhood T1DM cases in Beijing.
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Affiliation(s)
- Chunxiu Gong
- 1 Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University , Beijing, China
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Lu CL, Shen HN, Chen HF, Li CY. Epidemiology of childhood Type 1 diabetes in Taiwan, 2003 to 2008. Diabet Med 2014; 31:666-73. [PMID: 24499185 DOI: 10.1111/dme.12407] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 12/12/2013] [Accepted: 01/31/2014] [Indexed: 01/08/2023]
Abstract
AIMS To report the annual incidence rate and the socio-demographic and clinical characteristics of childhood Type 1 diabetes in Taiwan in the period 2003-2008. METHODS A total of 1306 incident cases of childhood (0-14 years) Type 1 diabetes were identified from Taiwan's National Health Insurance claim datasets from the period 2003-2008. The temporal trend of the incidence rate of Type 1 diabetes and the features of hospitalizations in the first year after diagnosis were investigated. The associations of patient characteristics, child population density and the urbanization level of the residential areas with the risk of Type 1 diabetes were assessed using Poisson regression analysis. RESULTS The annual incidence rate was stable, irrespective of age and gender, with a mean annual incidence rate of 5.3 per 100 000 children. Girls were more likely than boys to develop Type 1 diabetes (6.0 vs 4.7 per 100 000 children) and the incidence rate increased with age. There was no apparent geographic variation in the incidence rates. Despite the 60% decrease in the rate of admission (from 11.0 to 5.8%) over the study period, ketoacidosis remained the major diabetes complication leading to admission for childhood Type 1 diabetes. The multivariate analysis suggested that female gender and older age were significant predictors of the incidence of Type 1 diabetes, whereas the population density of children and the urbanization levels of the residential areas were not. CONCLUSIONS Girls and older children should receive particular attention when formulating preventive strategies targeting Type 1 diabetes. Additionally, clinicians should still carefully optimize the management of children with Type 1 diabetes to further reduce the occurrence of ketoacidosis.
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Affiliation(s)
- C-L Lu
- Department of Medical Research, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan; Department and Institute of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
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Chan JCN, Deerochanawong C, Shera AS, Yoon KH, Adam JMF, Ta VB, Chan SP, Fernando RE, Horn LC, Nguyen TK, Litonjua AD, Soegondo S, Zimmet P. Role of metformin in the initiation of pharmacotherapy for type 2 diabetes: an Asian-Pacific perspective. Diabetes Res Clin Pract 2007; 75:255-66. [PMID: 16876285 DOI: 10.1016/j.diabres.2006.06.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2006] [Accepted: 06/22/2006] [Indexed: 11/30/2022]
Abstract
Increases in the prevalence of type 2 diabetes of 30-60% will occur in many Asian-Pacific countries by 2025, driven by urbanisation, sedentary habits and energy-rich diets. Obesity, insulin resistance, metabolic syndrome and diabetes are closely interrelated. Optimal control of diabetes and associated risk factors has reduced the risk of diabetes-related complications. In the UK Prospective Diabetes Study (UKPDS), metformin reduced the risk of macrovascular complications and retrospective analyses have confirmed the efficacy of metformin in improving clinical outcomes in type 2 diabetic patients with a history of cardiovascular disease. This growing body of evidence has led to the recommendation of metformin as optimum initial pharmacotherapy in overweight type 2 diabetic patients. Obesity is less prevalent in the Asian-Pacific population than in Caucasian populations. Nevertheless, metformin has multiple beneficial metabolic effects, which provide sufficient rationale for it to be recommended as the initial oral anti-diabetic pharmacotherapy, alone or in combination, irrespective of body mass index. This recommendation is consistent with global guidelines and regional recommendations for the Asian-Pacific region from the International Diabetes Federation. These recommendations can serve as templates for development of local guidelines for Asian people with diabetes, given the ethnic and cultural diversity within the region.
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Affiliation(s)
- Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, Hongkong.
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12
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Joshy G, Simmons D. Diabetes information systems: a rapidly emerging support for diabetes surveillance and care. Diabetes Technol Ther 2006; 8:587-97. [PMID: 17037973 DOI: 10.1089/dia.2006.8.587] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND With the rapid advances in information technology in the last decade, various diabetes information systems have evolved in different parts of the world. Availability of new technologies and information systems for monitoring and treating diabetes is critical to achieving recommended metabolic control, including glycosylated hemoglobin levels. The first step is to develop a registry, including a patient identifier that can link multiple data sources, which can then serve as a springboard to electronic mechanisms for practitioners to gain information on performance and results. OBJECTIVE The aim is to review the provisions for diabetes surveillance in different parts of the world. This is a systematic review of national and regional information systems for diabetes surveillance. LITERATURE REVIEW A comprehensive review was undertaken using Medline literature review, internet search using the Google search engine, and e-mail consultation with opinion leaders. TOPICS REVIEW: National/regional-level diabetes surveillance systems in Europe, the United States, Australia/New Zealand, and Asia have been reviewed. State-of-the-art diabetes information systems linking multiple data sources, with extensive audit and feedback capabilities, have also been looked at. RESULTS National/regional-level audit databases have been tabulated. Diabetes information systems linking multiple data sources have been described. Most of the developed countries have now implemented systems such as diabetes registers and audits for diabetes surveillance in at least some regions, if not nationally. Developing nations are beginning to recognize the need for chronic disease management. CONCLUSIONS With the advancements in information technology, the diabetes registers have the potential to rise beyond their traditional functions with dynamic data integration, decision support, and data access, as demonstrated by some diabetes information systems. With the rapid pace of development in electronic health records and health information systems, countries that are beginning to build their health information technology infrastructure could benefit from planning and funding along these lines.
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Affiliation(s)
- Grace Joshy
- Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
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Gungor N, Hannon T, Libman I, Bacha F, Arslanian S. Type 2 diabetes mellitus in youth: the complete picture to date. Pediatr Clin North Am 2005; 52:1579-609. [PMID: 16301084 DOI: 10.1016/j.pcl.2005.07.009] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Type 2 diabetes mellitus is a heterogeneous condition in which the clinical manifestation of hyperglycemia is a reflection of the impaired balance between insulin sensitivity and insulin secretion. Clinical experience and research in youth type 2 diabetes mellitus are in an early stage because of the relative novelty of the condition in pediatrics. This article discusses the amassed information in type 2 diabetes mellitus of youth to date with respect to the epidemiology, pathophysiology, risk factors, clinical presentation, screening, and management strategies.
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Affiliation(s)
- Neslihan Gungor
- Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA
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Affiliation(s)
- Orit Pinhas-Hamiel
- Pediatric Endocrinology and Diabetes Unit, Sheba Medical Center, Tel Hashomer, Ramat-Gan and Maccabi Juvenile Diabetes Center, 4 Bar-Ilan Street, Rananna, Israel
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