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Incidence of type 1 diabetes mellitus during 26 years of observation and prevalence of diabetic ketoacidosis in the later years

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Abstract

The prevalence of type 1 diabetes (T1D) varies greatly between countries. However, over the past several decades, a global rise in the incidence of T1D in the pediatric population has been noted. The aim of our study was to investigate the incidence of T1D in children living in the Lesser Poland during the period of time from January 1, 1987, to December 31, 2012, and to analyze the demographic characteristics and occurrence of diabetic ketoacidosis (DKA) in patients with newly diagnosed T1D in the second part of the study (2006–2012). During 26 years, 636 children (331 boys, 305 girls) aged 0–14 years were newly diagnosed with T1D (0–4 years old, n = 131; 5–9 years old, n = 253, 10–14 years old, n = 252). The standardized incidence ratio (SIR) ranged significantly (p < 0.001) from 5.2/100,000/year in 1987 to 21.9/100,000/year in 2012. The highest SIR was observed in age group 5–9 years old (21.2) and the lowest in 0–4 years old (8.8). There was no association with sex or living in urban or rural area. On admission, DKA was diagnosed in 22.4 % of patients. There were no significant differences relating to the presence of DKA (p = 0.912) in subsequent years.

Conclusions: The incidence of T1D among children is increasing rapidly with the highest SIR in the 5–9 years old age group. DKA is still an important problem in the pediatric population.

What is Known:

• The incidence of pediatric type 1 diabetes mellitus in Europe is increasing. The initial manifestation of the type 1 diabetes mellitus is diabetic ketoacidosis.

What is New:

• This is the longest (26 years) continuous analysis of the incidence of type 1 diabetes in Poland and the first analysis focused on the incidence rate and also on presence of diabetic ketoacidosis.

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Abbreviations

DKA:

Diabetic ketoacidosis

GUS:

The Central Statistical Office (Polish: Glowny Urzad Statystyczny, GUS)

SIR:

Standardized Incidence Ratio

LP:

Lesser Poland (Polish: wojewodztwo krakowskie)

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Acknowledgments

First and foremost, we would like to thank our colleagues from our scientific group - Magdalena Wolek, Agata Krawczyk, Agnieszka Kobylka, Paulina Miskiewicz for their help with collecting data for our research. They inspired us greatly to work on this project. Besides, we would like to thank the faculty of the Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Polish- American Pediatric Institute, Jagiellonian University Collegium Medicum for providing data records. We thank Agnieszka Kieltyka M.D. for statistical calculations.

We thank Dr. Karolina Poplawska for reviewing the manuscript

Conflict of interest

The authors declare that they have no conflict of interest. No competing interests.

Authors’ contributions

Malgorzata Wojcik conception and design, acquisition of data, analysis and interpretation of data, preparation of the manuscript. Barbara Wasyl and Malgorzata Sudacka acquisition of data, analysis and interpretation of data, preparation of the manuscript. Marta Ciechanowska conception and design, acquisition of data, analysis and interpretation of data. Joanna Nazim and Malgorzata Stelmach acquisition of data. Jerzy B. Starzyk conception and design, preparation of the manuscript.

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    Authors and Affiliations

    1. Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland

      Malgorzata Wojcik, Joanna Nazim & Jerzy B. Starzyk

    2. Department of Pediatric and Adolecent Endocrinology, Children’s University Hospital of Krakow, Krakow, Poland

      Malgorzata Wojcik, Marta Ciechanowska, Joanna Nazim, Malgorzata Stelmach & Jerzy B. Starzyk

    3. Student’s Scientific Group, Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland

      Malgorzata Sudacka & Barbara Wasyl

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    1. Malgorzata Wojcik
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    Correspondence to Malgorzata Wojcik.

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    Communicated by Beat Steinmann

    Malgorzata Sudacka and Barbara Wasyl contributed equally to this work.

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    Wojcik, M., Sudacka, M., Wasyl, B. et al. Incidence of type 1 diabetes mellitus during 26 years of observation and prevalence of diabetic ketoacidosis in the later years. Eur J Pediatr 174, 1319–1324 (2015). https://doi.org/10.1007/s00431-015-2537-1

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    • DOI: https://doi.org/10.1007/s00431-015-2537-1

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