27 May, 2009 -- The incidence of type 1 diabetes among very young children looks set to double (from 2005 figures) in just over a decade if present trends continues. These are the findings that have emerged from a new study carried out by researchers at Queen’s University, Ireland.
The prediction is based on type 1 diabetes trends in Europe. Researchers are convinced that environmental exposures are driving the increase, but it is far from clear what those exposures are.
Once known as juvenile diabetes, type 1 diabetes is much less common than type 2 diabetes, except among children and adolescents.
The most common age of diagnosis is normally the early teen years. However, the new study suggests that the burden may now be shifting toward younger children.
"We are likely to see more children with severe diabetes complications presenting at earlier ages if we fail to recognise and adequately treat disease in very young patients," says Dr. Christopher Patterson, the epidemiologist who headed the study.
In a May issue of The Lancet, Patterson and colleagues concluded that rates of type 1 diabetes among children and young teens are increasing faster than previous predictions suggested.
Patterson and colleagues analysed data from European registries, which included information on more than 29,000 children with type 1 diabetes, enrolled between 1989 and 2003.
They found that:
- The overall increase in incidence of type 1 diabetes was 3.9% per year.
- The increase was greatest among children under five, who saw increases of 5.4% per year compared to an annual increase of 4.3% among children between the ages of five and nine and 2.9% among children between the ages of 10 and 14.
- If present trends continue, total cases of disease are projected to rise by 70% by 2020 and rates among children under five will double.
Reasons for increase in type 1 diabetes
Patterson believes that, because the increases are occurring so quickly, it is likely that environmental influences are driving the trend.
Researchers are examining a wide range of possible environmental triggers, including early-life diet, viral infection, and even Caesarean births, but they still have more questions than answers.
"Being born to an older mother and having a Caesarean delivery seems to be associated with slight increases in risk,” says Patterson, “But neither one of these factors is sufficient to explain the increases we are seeing.”
Meanwhile, Professor Dana Dabelea, an epidemiologist at the University of Colorado, believes that another key factor to consider is rapid early growth due to improved early-life nutrition.
Dabelea is a co-investigator on the SEARCH for Diabetes in Youth Study. This is an American health initiative where children with type 1 and type 2 diabetes, in different areas in the US, are being monitored in an effort to better understand diabetes trends in non-adults.
In 2007, Dabelea and colleagues reported higher-than-predicted rates of type 1 diabetes amongst children in the US. The increase was most pronounced among non-Hispanic white children.
In an editorial accompanying this new study, Dabelea called for more research on type 1 and type 2 diabetes in children.
"It is imperative that efforts directed at surveillance of diabetes in young people continue and expand, not only to understand its complex etiology, but also because of the increasing public health importance.”
Posts
0 comments
Post a Comment