Prevalence of type 2 diabetes mellitus among Kuwaiti children and adolescents.

OBJECTIVES: To determine the prevalence of type 2 diabetes among 6- to 18-year-old Kuwaiti children. SUBJECTS AND METHODS: Children with type 2 diabetes were identified at 182 schools (50 primary, 63 intermediate, and 69 secondary) randomly selected using the 2000/2001 educational districts' registers as a sampling frame. Prevalence rates were adjusted to the 2002 Kuwaiti population. Diagnosis of type 2 diabetes was based on the World Health Organization and the American Diabetes Association criteria. RESULTS: Type 2 diabetes was identified in 45 of the 128,918 children surveyed, thereby giving an overall prevalence of 34.9 per 100,000 [95% confidence interval (CI) 24.7-45.1]. There was a significant difference in prevalence between males (47.3, 95% CI 28.7-65.8) and females (26.3, 95% CI 14.8-37.8) at p = 0.05 and a significant trend for an increase in prevalence of type 2 diabetes with age (p = 0.026). The overall age-adjusted prevalence rate in the 2002 Kuwaiti population was 33.2 (95% CI 26.6-39.9), 41.6 (95% CI 31.2-52.0) in male and 24.6 (95% CI 16.4-32.7) in female children; the difference was significant at p = 0.013. There was no significant difference in prevalence between regions. Children with type 2 diabetes had a significantly higher frequency (51.1%) of a positive family history of diabetes than children of a similar age without type 2 diabetes (22.2%) (p = 0.004). CONCLUSION: The prevalence of type 2 diabetes in adult Kuwaitis is spreading to children and adolescents, making it an emergency public health problem. Efforts need to be initiated to address prevention strategies of type 2 diabetes in youth.

Prevalence of type 1 diabetes among 6- to 18-year-old Kuwaiti children.

OBJECTIVES: To determine the prevalence of type 1 diabetes among 6- to 18-year-old Kuwaiti children according to gender, age, and region. SUBJECTS AND METHODS: Children with type 1 diabetes aged 6-18 years were identified at 182 schools (50 primary, 63 intermediate, and 69 secondary) in Kuwait during the study period October 2000 to September 2002. Schools were randomly selected using the 2000/01 educational districts' registers as sampling frame proportional to the number of schools in each district. Prevalence rates were adjusted to the 2002 Kuwaiti population. Diagnosis of type 1 diabetes was based on the World Health Organization, and the American Diabetes Association criteria. RESULTS: Prevalence of type 1 diabetes was 269.9 per 100,000 (95% confidence interval, CI 241.6-298.3). There was no significant difference in prevalence between male (247.6, 95% CI 205.2-290.0) and female (285.5, 95% CI 247.5-323.5). Type 1 diabetes was more prevalent in the age group 10-13 years (347.3), and lowest in the age group 6-9 years (182.6) per 100,000; the difference was significant at p < 0.001. The overall age-adjusted prevalence rate was 252.9 (95% CI 234.6-271.2), 229.1 (95% CI 204.6-253.6) in male and 277.4 (95% CI 250.0-304.7) in female children in the 2002 Kuwaiti population. The mean age at onset was 9.2, and 8.1 years in male and female children, respectively (p = 0.018). There was no significant difference in prevalence between regions. CONCLUSION: Type 1 diabetes is a common chronic disease in Kuwaiti children.

Association of serum sialic acid with cardiovascular metabolic risk factors in Kuwaiti children and adolescents with type 1 diabetes.

The aim of the present study was to investigate the relation of serum total sialic acid (TSA) concentrations with cardiovascular metabolic risk factors in Kuwaiti children and adolescents with uncomplicated type 1 diabetes. This case-control study included 150 (57 males and 93 females) type 1 diabetic children aged 6 to 18 years matched by age and sex to 150 nondiabetic children as controls. Measured variables included weight, height, systolic, diastolic blood pressure, and biochemical variables: blood glucose, glycated hemoglobin (HbA(1C)), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), apolipoproteins (apo) A1 and B, and urine microalbumin. There was no significant difference between mean serum TSA of the type 1 diabetic children (671.0 mg/L) and their controls (663.7 mg/L). In diabetic children, mean serum TSA was significantly higher in females (699.1 mg/L) than in males (625.2 mg/L) (P =.003). Significant correlations were found between serum TSA and the cardiovascular risk factors TC (P =.002), TG (P <.001), and apo B (P =.008). TSA mean level was significantly higher in diabetic children with poor glycemic control (HbA(1C) > 9.0%; P =.015), raised TC (P =.013), raised TG (P =.014), and in children with family history of cardiovascular disease (CVD; P =.02). In conclusion, the study suggests that serum TSA levels were not elevated in young type 1 diabetic children as compared with controls. The study also confirmed significant correlation of TSA concentrations with CVD risk factors TC, TG, and apo B, and as such serum TSA may be considered as a marker for CVD risk, especially in diabetic patients. A long-term prospective study is recommended to ascertain the longitudinal relationship of serum TSA with the adverse metabolic changes in type 1 diabetic children as complications prevail.