Incidence of IDDM during 1988?1992 in Zagreb, Croatia

Abstract

SummaryThe objective of this study was to determine the incidence of insulin-dependent diabetes mellitus (IDDM) in the population of Zagreb, Croatia, during 1988Croatia, during -1992. A centralized diabetes registry was the primary source of data, while secondary sources were used to assess ascertainment. A total of 282 new cases of IDDM were diagnosed in the study period, the primary and secondary sources identifying annually 93-100 % of the cases. The annual incidence rate ranged from 5.6 per 100,000 to 6.6 per 100,000. Early fatality in persons older than 50 years was the major cause of underascertainment. The incidence peaked in the 10-14 years age group (12.4 per 100,000), and remained stable after age 24years. Males had a significantly higher incidence in the 5-9 and 24-44 years age groups. In the 45-54 years age group, females had a significantly higher incidence. No seasonality was observed. Despite the war conditions in Croatia, the low overall IDDM incidence rates did not change significantly during the study period. [Diabetologia (1995) 38: 550-554]

Epidemiology, Clinical Aspects, and Biology of IDDM Patients Under Age 40 Years: Comparison of data from Antwerp with complete ascertainment with data from Belgium with 40% ascertainment. The Belgian Diabetes Registry

“…However, in the age-group 15-39 years, the incidence rates decrease with age in females older than age 15, but not in males, resulting in twofold higher incidence rate in males than in females. This sex-dependent difference in risk in older age-groups has also been observed in other countries with an intermediate or high risk (Croatia [13], Italy [Turin {16}], Norway [17], Sardinia [18], Spain [19], Sweden [23], Denmark [14]), but not in regions with a low risk (Barbados [20], Poland [21], Pavia [22]). It may be caused by the effect of sex hormones as well as by lifestyle factors, such as obesity, physical activity, and diet, as recently shown for NIDDM (38).…”

“…The present data indicate that the incidence rate of IDDM among adult diabetic patients is higher than previously expected. Meta-analysis of data from other regional and national diabetes registries studying the diabetic population above age 15 years (Denmark [8], Croatia [13], Italy [Turin (15,16), Pavia (22)], Sardinia [18], Spain [19], Poland [21]) has already revealed this notion. Although data are not yet available, it is conceivable that a comparable number of IDDM patients become clinically overt above the age of 40 years.…”

“…However, it is important to study older age-groups as well, since there are indications that a non-negligible number of cases, if not the majority, arise at adult age (6-10). Some reports have described a second incidence peak in late adulthood arising around 50-60 years (8,(11)(12)(13), apart from the well-known peak around puberty (4). Several diabetes registries have extended their age range above age 15 years (6,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23); it thus became more evident that IDDM is a heterogeneous disease in terms of demographic and clinical presentation (6,10,12,13,(17)(18)(19)23).…”

The burden of diabetes and use of diabetes care in humanitarian crises in low-income and middle-income countries

“…All studies were published between 1992 and 2018, with thirty-three published since 2011. Thirty-eight studies reported on populations affected by armed conflict, [17][18][19][20][21][22][23][24][25][27][28][29][30][31][32][33]35,36,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] two reported on populations affected by natural disasters, 34,37 and one on all crisis types. 26 Thirty-four studies were conducted in the protracted crisis phase (crisis duration greater than six months), [17][18][19][20][21][22][23][24][25]…”

“…26,37 Twenty-five studies addressed refugee populations, [17][18][19][20][21]25,26,[29][30][31]33,35,[39][40][41][42][43]47,48,50,[52][53][54][55]57 five addressed IDPs, 22,28,32,46,56 and eleven addressed non-displaced conflict-affected populations. 23,24,27,34,[36][37][38]44,45,49,51 The majority of studies were conducted in the WHO Eastern Mediterranean (N=30), [17][18][19][20][21][22][23][24][28]…”