Incidence trends of childhood type 1 diabetes in eastern Saudi Arabia

To assess the epidemiology and incidence rate of type 1 diabetes in children <15 years of age in a subpopulation in the eastern province of the Kingdom of Saudi Arabia[KSA]. This is a subpopulation-based observational incidence study. Admission dates, diagnosis, age, and gender were collected for all Saudi children <15 years of age with new onset type 1 diabetes that received medical care at the Saudi Aramco Medical Services Organization, Dhahran Health Center, Dhahran, KSA during the period 1990-2007. The case ascertainment rate was estimated to be 100%. There were 438 patients diagnosed during the study period. The average incidence rate was 27.52/100, 000/year [95% CI: 26.72-28.32], increasing from 18.05/100,000/year in the first 9 years of the study period to 36.99/100,000/year in the last 9 years. Twenty-one percent of patients were <5 years of age, with no significant difference in the rate of increase in the incidence rate of this age group compared to the older age groups. Of the total patients, 55% were females, and 40% presented with diabetic ketoacidosis. The incidence rate of childhood type 1 diabetes increased alarmingly over the past 18 years in our study population. A Kingdom-wide diabetes registry is essential to study the epidemiology of this disease in the whole country

Unusual occurrence of cystic fibrosis and alobar holoprosencephaly

Holoprosencephaly [HPE] is a defect of embryonic forebrain resulting from failure of growth and segmentation of the anterior end of the neural tube. It has been classified into 4 types based on the severity of associated brain and facial malformations. The most severe variety called alobar HPE is generally associated with major cranio-facial anomalies such as cyclopia, ethmocephaly, cebocephaly, or cleft-lip/palate. Significant etiological heterogeneity exists in HPE and includes both genetic and environmental causes. Maternal diabetes is a well-established environmental factor with a significant increased risk for HPE. We report on a Saudi Arab girl born to a diabetic mother, with the alobar type of holoprosencephaly, associated with very minimal cranio-facial defects. However, she displayed several other congenital malformations. In addition, she was diagnosed with cystic fibrosis. Simultaneous occurrence of cystic fibrosis and congenital anomalies has been rare