Type 1 diabetes incidence in children and adolescents in Mexico: Data from a nation-wide institutional register during 2000–2018

Wacher, Niels H.; Gómez-Díaz, Rita A.; Ascencio-Montiel, Iván de Jesús; Rascón-Pacheco, Ramón Alberto; Aguilar-Salinas, Carlos A.; Borja-Aburto, Víctor Hugo

doi:10.1016/j.diabres.2019.107949

Cited by 12 publications

(7 citation statements)

References 37 publications

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“…Similarly, we identified a cluster of significantly higher diabetes-related excess mortality and large increases in the ratio of out-of-hospital to in-hospital mortality in the southeast region of Mexico; notably, this region displayed a spatial correlation between excess diabetes-related out-of-hospital deaths and both DISLI and increased rates of suboptimal glycemic management, suggesting that this region was particularly vulnerable to socio-demographic inequalities in diabetes care. The regional differences in diabetes-related excess mortality for type 1 diabetes (highest in northern Mexico) compared to those observed for type 2 diabetes (highest in southern Mexico) mirror the regional differences in prevalence for each condition 2 , 19 , 25 , 26 .…”

Section: Discussionmentioning

confidence: 73%

Diabetes-Related Excess Mortality in Mexico: A Comparative Analysis of National Death Registries Between 2017–2019 and 2020

et al. 2022

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OBJECTIVE To estimate diabetes-related mortality in Mexico in 2020 compared with 2017–2019 after the onset of the coronavirus disease 2019 (COVID-19) pandemic. RESEARCH DESIGN AND METHODS This retrospective, state-level study used national death registries of Mexican adults aged ≥20 years for the 2017–2020 period. Diabetes-related death was defined using ICD-10 codes listing diabetes as the primary cause of death, excluding certificates with COVID-19 as the primary cause of death. Spatial and negative binomial regression models were used to characterize the geographic distribution and sociodemographic and epidemiologic correlates of diabetes-related excess mortality, estimated as increases in diabetes-related mortality in 2020 compared with average 2017–2019 rates. RESULTS We identified 148,437 diabetes-related deaths in 2020 (177 per 100,000 inhabitants) vs. an average of 101,496 deaths in 2017–2019 (125 per 100,000 inhabitants). In-hospital diabetes-related deaths decreased by 17.8% in 2020 versus 2017–2019, whereas out-of-hospital deaths increased by 89.4%. Most deaths were attributable to type 2 diabetes (130 per 100,000 inhabitants). Compared with 2018–2019 data, hyperglycemic hyperosmolar state and diabetic ketoacidosis were the two contributing causes with the highest increase in mortality (128% and 116% increase, respectively). Diabetes-related excess mortality clustered in southern Mexico and was highest in states with higher social lag, rates of COVID-19 hospitalization, and prevalence of HbA1c ≥7.5%. CONCLUSIONS Diabetes-related deaths increased among Mexican adults by 41.6% in 2020 after the onset of the COVID-19 pandemic, occurred disproportionately outside the hospital, and were largely attributable to type 2 diabetes and hyperglycemic emergencies. Disruptions in diabetes care and strained hospital capacity may have contributed to diabetes-related excess mortality in Mexico during 2020.

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Section: Discussionmentioning

confidence: 73%

Diabetes-Related Excess Mortality in Mexico: A Comparative Analysis of National Death Registries Between 2017–2019 and 2020

et al. 2022

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“…On the other hand, BDI-II score was higher in caregivers with burden compared to those without burden [12.5 (6.5–16.5) vs . 4 ( 2 – 7 ); p = 0.002]. There were no differences in gender, relationship, scholarliness, occupation, marital status, family APGAR score, and patient clinical parameters as age, gender, and diabetes control ( Tables 1 , 2 ).…”

Section: Resultsmentioning

confidence: 92%

“…T1D is one of the most frequent chronic diseases in childhood and its incidence is increasing worldwide. In Mexico, the incidence of T1D in children and adolescents is fluctuating, with a reported incidence of 3.4 to 2.8 per 100,000 between 2000 and 2018 in subjects under 20 years of age, which represents an important health problem in our population ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?

Balcázar-Hernández

Huerta-Martínez²,

Magaña³

et al. 2023

Front. Endocrinol.

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ObjectiveThe requirement of a chronic treatment and the increase in life expectancy in children with type 1 diabetes (T1D) leads to the possibility of caregiver burden. The aim of our study was to evaluate the burden in primary informal caregivers (PIC) of children and adolescents with type 1 diabetes and its association with depression, family dysfunction, and glycemic control.Materials and methodsA retrospective study was performed in PIC of children and adolescents with T1D. Zarit Burden Interview Scale (ZBIS) was used to evaluate caregiver burden. Beck Depression Inventory (BDI-II) was used to evaluate depression in PIC, and the Family APGAR questionnaire was used to evaluate the family functionality.ResultsA total of 100 PIC of children and adolescents with T1D were included. Caregiver burden was found in 33% of caregivers. The total score of the Zarit scale was 41 (34–49); 19% had mild caregiver burden, and 14% had severe caregiver burden. According to the BDI-II, 82% had minimal depression, 11% mild depression, 5% moderate depression, and 2% severe depression. Family function was good in 69%; 13% had moderate dysfunction, and 18% had severe dysfunction. A positive correlation between caregiver burden and BDI-II score (r = 0.84; p = 0.001) and the grade of depression (r = 0.87; p = 0.001) was found. A logistic regression model showed that BDI-II score was associated with caregiver burden (OR 1.14; 95% CI 1.061–1.23; p = 0.001). A BDI-II cut off of 9 or more had a sensibility and specificity of 58% and 28%, respectively, for caregiver burden [AUC 0.751 (0.64–0.85); p = 0.001]. A BDI-II score ≥9 was a predictor of caregiver burden (OR 3.4; 95% CI 1.4–8.1; p = 0.008).ConclusionCaregiver burden is present in more than one third of the PIC of patients with T1D and is associated with depression. A BDI-II score ≥9 is a predictor of caregiver burden which may be a point to take into account in the integral approach to the patient with T1D and his or her family nucleus.

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“…However, the lack of any rise in incidence is difficult to explain. Only three other countries in the region have longitudinal data, with incidence rising in Chile 16 and Brazil, 17 but not in Mexico 15 …”

Section: Discussionmentioning

confidence: 99%

“…1,2,9 Incidence is highest in northern-European-origin populations, and also some Arab populations in the Middle East and North Africa. [10][11][12] With respect to neighboring countries to Dominican Republic that have 0-14 y data, the identified incidence of 4.3 per 100,000 population was higher than Colombia and Bolivia (both 2.2), 13,14 and Mexico (3.2), 15 but substantially lower than Chile (13.9) 16 and Brazil (16.3). 17 The reasons for the wide variation in the region are unclear.…”

Section: Discussionmentioning

confidence: 99%

Incidence of type 1 diabetes in children in Dominican Republic, 2010–2019: A national collaborative study

Morla¹,

Ibrahim

James

et al. 2022

Pediatric Diabetes

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The Dominican Republic has no recent data on type 1 diabetes (T1D) incidence in children. Therefore, a study was undertaken to determine this in persons aged <15 years (y). Data were collected on all new T1D diagnoses between 2010–2019 from the four institutions caring for children with T1D. Diagnosis was made according to standard criteria. No secondary ascertainment source was available. The trend and the effect of age and sex of T1D incidence was analyzed using Poisson regression. A total of 1224 new cases of T1D were diagnosed <15 y; mean ± standard deviation (range) 122 ± 12 (96–135) cases per year. Age at T1D diagnosis was 8.8 ± 3.7 y, with a significant female preponderance (n = 708, 57.8%, p < 0.001). When examined per 5‐y age group, cases were consistently highest in 10–14 y, and lowest in 0–4 y in all study years. Mean crude T1D annual incidence was 4.3 (95% CI 3.5–5.1) per 100,000 population. There was no significant difference between incidence across the country's three departments (regions): Southeast (4.4 [3.4–5.7]/100,000 population), North (4.1 [2.9–5.6]), and Southwest (3.9 [2.4–5.9]). Mean standardized annual incidence was 4.1 (4.1–4.2) per 100,000 population, with no significant trend of increase over the study period. The incidence of T1D in children aged <15 y is relatively low in Dominican Republic, but consistent with the limited data from other countries in the region. However, the incidence is eight times higher than the previous estimate during 1995–1999. Ongoing surveillance is warranted.

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Type 1 diabetes incidence in children and adolescents in Mexico: Data from a nation-wide institutional register during 2000–2018

Cited by 12 publications

References 37 publications

Diabetes-Related Excess Mortality in Mexico: A Comparative Analysis of National Death Registries Between 2017–2019 and 2020

Diabetes-Related Excess Mortality in Mexico: A Comparative Analysis of National Death Registries Between 2017–2019 and 2020

Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?

Incidence of type 1 diabetes in children in Dominican Republic, 2010–2019: A national collaborative study

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