Regional differences in incidence and clinical presentation of type 1 diabetes in children aged under 15 years in Croatia

Abstract

AimTo determine regional differences in the incidence, incidence trends, and clinical presentation of type 1 diabetes in children under the age of 15 years in Croatia in a 9-year period (1995-2003).MethodsWe included the patients who had been diagnosed with the disease and had started the insulin treatment before they were 15 years old. Regional differences between eastern, central, and southern Croatia were observed. The gross incidence was expressed by the number of newly diagnosed type 1 diabetes patients in 100 000 children of the same age and sex per year, ie, for the 0-14 age group, and for the 0-4, 5-9, and 10-14 subgroups.ResultsThe highest incidence was observed in southern Croatia (10.91 per 100 000/y) and the lowest in central Croatia (8.64 per 100 000/y), and in eastern Croatia the incidence was 8.93 per 100 000/y. All three regions showed a growing incidence trend, which was significant only in eastern and southern Croatia. There was 35.9% of patients with diabetic ketoacidosis in eastern Croatia, 41.7% in central Croatia, and 31.3% in southern Croatia.ConclusionCroatian regions show differences in the incidence, incidence trends, and disease presentation of type 1 diabetes. A further follow-up is needed to establish whether the regional differences are a consequence of the population dynamics in the observed period or they will continue to exist, pointing to differences in environmental risk factors.

High prevalence of diabetic ketoacidosis in children with newly diagnosed type 1 diabetes in Belgrade, Serbia: 10-year tertiary centre experience

“…diagnosed T1DM patients had DKA, which, together with the DKA incidence of 32.9% reported by the study performed at the University Children's Hospital in Belgrade, provides a complete insight and confirms the alarmingly high frequency of DKA at the time of diagnosis of T1DM in youth living in Belgrade (18). Similar worrisome DKA frequencies at T1DM onset were reported in other countries in the region, such as Croatia (31.3-41.7%) and Bosnia (48%) (21,22), although data from Montenegro showed a significantly lower incidence of 24.5% (23).…”

Economic evaluation of continuous subcutaneous insulin infusion for children with diabetes - a pilot study: CSII application for children – economic evaluation

“…The reimbursement practice in some countries provides such evidence, as in Serbia, where insurance authorities are paying for consumables and patients’ families are paying for pumps. In countries with high GDP, CSII is included within the scope of the reimbursement system [ 7 ].…”

“…Continuous subcutaneous insulin infusion (CSII) is a treatment option that can assist in achieving all of these goals in all ages of children [ 4 ]. European Union countries reimburse insulin therapy for individuals with health insurance, but for CSII reimbursement, a variety of approaches exist [ 5 - 7 ]. The objective of this study is to assess the cost of using CSII of insulin to treat children with type-1diabetes in Bulgaria and to compare it with the changes in BMI and HbA1c.…”

Economic Evaluation of Continuous Subcutaneous Insulin Infusion for Children with Diabetes—Part II

“…Continuous subcutaneous insulin infusion (CSII) is a treatment option that can assist in achieving all of these goals in all ages of children [4]. European Union countries reimburse insulin therapy for individuals with health insurance, but for CSII reimbursement, a variety of approaches exist [5][6][7]. The objective of this study is to assess the cost of using CSII of insulin to treat children with type-1 diabetes in Bulgaria and to compare it with the changes in BMI and HbA(1c).…”