Geographical variation of presentation at diagnosis of Type I diabetes in children: the EURODIAB Study

Lévy-Marchal, Claire; Patterson, C. C.; Green, A.

doi:10.1007/pl00002958

Cited by 226 publications

(204 citation statements)

References 8 publications

(10 reference statements)

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“…In a previous EURODIAB study [1] an inverse relationship between the diabetes incidence rate and the prevalence of DKA at onset of the disease was found, with DKA prevalence rates between 26 and 67%. A possible explanation for this association could be the greater medical awareness of diabetic symptoms in the population, especially family doctors, in high-incidence regions, but another reason might be other environmental differences leading to a more severe and rapid disease presentation.…”

Section: Discussionmentioning

confidence: 77%

“…Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes and is present in 15-67% of children at the time of diagnosis [1][2][3][4][5][6][7]. The prevalence of onset DKA varies widely among studies, but most studies have been hospital-based and might therefore have been influenced by the selection bias of hospital referral [2,4,6].…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of onset DKA varies widely among studies, but most studies have been hospital-based and might therefore have been influenced by the selection bias of hospital referral [2,4,6]. There is substantial variation in the incidence rate of type 1 diabetes in children below 15 years in Europe and the regional incidence rate of type 1 diabetes has been reported to be inversely correlated with the prevalence of DKA at diagnosis [1,8].…”

Section: Introductionmentioning

confidence: 99%

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Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

2010

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Aim The aim of the study was to analyse the prevalence of diabetic onset ketoacidosis (DKA) during a period of 20 years (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)) on a population basis in the whole of Austria. Methods A prospective population-based incidence study (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) was performed. The registered data set comprised blood glucose, pH, ketonuria and clinical symptoms of DKA at manifestation. DKA was defined as pH<7.3 and severe DKA as pH<7.1. Time trends were estimated using linear regression models. Results During the study period, 3331 children <15 years of age (1,797 boys and 1,534 girls) were registered with newly diagnosed type 1 diabetes. Of these, 1,238 (37.2%) presented with DKA, 855 (25.7%) had a mild and 383 (11.5%) a severe form, and one patient died at onset. DKA frequency was negatively associated with age at onset (p< 0.0001). In children <2 years the prevalence was 60%, with a higher risk for girls (70% vs 54% for boys, p<0.05). Despite a significant increase in diabetes incidence in Austria during the observation period from 8.4 to 18.4/ 100,000 (p<0.0001), no significant change in the prevalence of DKA at manifestation was observed. Conclusions The overall frequency of DKA in children with newly diagnosed type 1 diabetes in Austria is high and has not changed during the last 20 years despite a clear increase in the manifestation rate. In particular, children less than 2 years of age have a high risk of DKA at onset.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

2010

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“…Using the EURODIAB database, an inverse correlation was found between the frequency of ketoacidosis at onset and incidence rate. Up to 60 percent of cases had ketoacidosis at diagnosis in low incidence countries [24].…”

Section: Descriptive Epidemiology Of Type 1 Diabetes In Europementioning

confidence: 99%

Diabetes in the young: a paediatric and epidemiological perspective

Soltész

2003

Diabetologia

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The spectrum of diabetes in the young has widened; it now includes monogenic diseases, for example the various forms of permanent and transient neonatal diabetes and MODY as well as the emerging obesityassociated Type 2 diabetes in late childhood, but the main form is still Type 1 diabetes. Age-related major medical, physiological, social and emotional problems make the clinical management of diabetes in children and adolescents a difficult task for the physician and the family. Overall glycaemic control remains moderate or poor despite a treatment schedule, which interferes with several elements of "normal" childhood.There is an up to tenfold geographical variation in the incidence of childhood Type 1 diabetes within Europe with relatively stable incidence rates in some countries (mainly northern), but dynamic increases in incidence in other countries (mainly central European).A number of nongenetic (environmental) factors have been associated with the risk of Type 1 diabetes.

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“…The ratio inversely correlates with the regional incidence of T1DM. Frequencies range from 15 to 70% in Europe, Australia, and North America [11,[19][20][21][22][23][24][25]. The most occurrence ages of DKA are between the 18-44 years (56%), than 45-65 years (24%) continues with only 18% of patients <20 years of age.…”

Section: Introductionmentioning

confidence: 99%