No change in type 2 diabetes prevalence in children and adolescents over 10 years: Update of a population-based survey in South Germany

Neu, Andreas; Feldhahn, Lutz; Ehehalt, Stefan; Ziegler, Julian; Rothe, Ulrike; Rosenbauer, Joachim; Holl, Reinhard W.

doi:10.1111/pedi.12622

Cited by 26 publications

(23 citation statements)

References 12 publications

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“…Individuals diagnosed before 6 months of age now tend to be routinely investigated for monogenic forms of the disease [28], but the number of such cases is very small. Findings in the literature on whether or not type 2 diabetes is becoming more common in children and adolescents are inconsistent [29][30][31], but the distinction between the two types of diabetes is generally not difficult in the paediatric age group. Furthermore, European studies [30][31][32][33] confirm that the rate of type 2 diabetes is a small fraction of that of type 1 diabetes, and we do not therefore feel that misclassification of type 2 diabetes represents a serious challenge to the validity of our findings.…”

Section: Discussionmentioning

confidence: 99%

Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: a multicentre prospective registration study

et al. 2018

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Aims/hypothesis Against a background of a near-universally increasing incidence of childhood type 1 diabetes, recent reports from some countries suggest a slowing in this increase. Occasional reports also describe cyclical variations in incidence, with periodicities of between 4 and 6 years. Methods Age/sex-standardised incidence rates for the 0-to 14-year-old age group are reported for 26 European centres (representing 22 countries) that have registered newly diagnosed individuals in geographically defined regions for up to 25 years during the period 1989-2013. Poisson regression was used to estimate rates of increase and test for cyclical patterns. Joinpoint regression software was used to fit segmented log-linear relationships to incidence trends. Results Significant increases in incidence were noted in all but two small centres, with a maximum rate of increase of 6.6% per annum in a Polish centre. Several centres in high-incidence countries showed reducing rates of increase in more recent years. Despite this, a pooled analysis across all centres revealed a 3.4% (95% CI 2.8%, 3.9%) per annum increase in incidence rate, although there was some suggestion of a reduced rate of increase in the 2004-2008 period. Rates of increase were similar in boys and girls in the 0-to 4-year-old age group (3.7% and 3.7% per annum, respectively) and in the 5-to 9-year-old age group (3.4% and 3.7% per annum, respectively), but were higher in boys than girls in the 10-to 14-year-old age group (3.3% and 2.6% per annum, respectively). Significant 4 year periodicity was detected in four centres, with three centres showing that the most recent peak in fitted rates occurred in 2012. Conclusions/interpretation Despite reductions in the rate of increase in some high-risk countries, the pooled estimate across centres continues to show a 3.4% increase per annum in incidence rate, suggesting a doubling in incidence rate within approximately 20 years in Europe. Although four centres showed support for a cyclical pattern of incidence with a 4 year periodicity, no plausible explanation for this can be given.

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Section: Discussionmentioning

confidence: 99%

Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: a multicentre prospective registration study

et al. 2018

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“…However, while it is projected that by 2050 there may be a fourfold increase in the prevalence of youth‐onset T2DM in the United States, in a recent follow‐up survey of a cross‐sectional study, Neu et al . reported that the prevalence of youth‐onset T2DM in Germany remained stable over the past 10 years, and that the majority of youth‐onset T2DM cases were part of specific ethnic minorities (). Given the asymptomatic nature at T2DM followed by rapid progression with beta‐cell function deteriorating by 15–20% per year when diagnosed in young people and complications arising within 5 years, identification of individuals at high risk is crucial .…”

Section: Discussionmentioning

confidence: 99%

“…reported that the prevalence of youth-onset T2DM in Germany remained stable over the past 10 years, and that the majority of youth-onset T2DM cases were part of specific ethnic minorities ( 26,27 ). Given the asymptomatic nature at T2DM followed by rapid progression with beta-cell function deteriorating by 15-20% per year when diagnosed in young people and complications arising within 5 years, identification of individuals at high risk is crucial.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of prediabetes and type 2 diabetes in children with obesity and increased transaminases in European German‐speaking countries. Analysis of the APV initiative

et al. 2019

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Summary Background Non‐alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes mellitus are known to be closely linked with obesity as early as during childhood. Objectives The study aimed to determine the prevalence of prediabetes and T2DM in children with obesity with or without increased transaminases. Methods Data from the observational multicentre (n = 51), cross‐sectional Adipositas Patienten Verlaufsbeobachtung registry were analyzed. Mild increase (mild group) was defined by alanine transaminase (ALT) >24 to ≤50 U/L and moderate to severe increase (advanced group) by ALT > 50 U/L. Prediabetes and T2DM were defined according to recent IDF/ISPAD guidelines. Results The prevalence of prediabetes and T2DM was 11.9% (95% CI: 11.0–12.8) and 1.4% (95% CI: 1.1–1.7) among all participants (n = 4932; male = 2481; mean age 12.9 ± 2.7 years; BMI‐SDS 2.1 ± 0.5; Tanner stage 3.2 ± 1.5). The prevalence of impaired glucose metabolism (prediabetes and T2DM) was 13.8% (95% CI: 12.1–15.4) in the mild, 21.9% (95% CI: 18.8–25.1) in the advanced group, 10.7% (95% CI: 9.4–11.9) in the control group. Mild and advanced groups had greater odds ratios for prediabetes [1.42; 95% CI: 1.17–1.72, 2.26‐fold; (1.78–2.86), respectively], the advanced group also for T2DM [2.39 (1.36–4.21)] compared to controls. While an increase in transaminases predominantly affected boys, girls within the advanced group had a higher T2DM prevalence than males (5.4 vs. male 2.1%). Conclusions Children with obesity and increased liver transaminases as surrogates of NAFLD should be screened for T2DM.

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“…In Germany specialized hospitals offer in-patient rehabilitation following the National Guidelines set by the AWMF (S2-Leitlinie [7]) and the Leitlinien der Deutschen Diabetes-Gesellschaft (DDG) [12]. Average rehabilitation has a duration of four weeks.…”

Section: In-patient Rehabilitation In Germanymentioning

confidence: 99%

Rehabilitation in Germany 2004–2016 A Multicenter Analysis Over a Period of 13 Years in Children and Adolescents with Diabetes Mellitus

Schiel¹,

Stachow²,

Hermann³

et al. 2018

Exp Clin Endocrinol Diabetes

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No change in type 2 diabetes prevalence in children and adolescents over 10 years: Update of a population-based survey in South Germany

Cited by 26 publications

References 12 publications

Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: a multicentre prospective registration study

Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: a multicentre prospective registration study

Prevalence of prediabetes and type 2 diabetes in children with obesity and increased transaminases in European German‐speaking countries. Analysis of the APV initiative

Rehabilitation in Germany 2004–2016 A Multicenter Analysis Over a Period of 13 Years in Children and Adolescents with Diabetes Mellitus

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