ABSTRACT
The aim of this study was to evaluate the trends in the incidence of type 1 diabetes mellitus (DM) in children aged 0-14 years between 1987 and 1999 in three cities in Poland. The study area comprised the provinces of Cracow and Wroclaw and the city of Warsaw. The data were collected prospectively on the basis of the register within the framework of the EURODIAB study up till 1997 and then within the project of the Ministry of Health. During the 13 years of the study period, 766 children (380 girls, 386 boys) with newly diagnosed type 1 DM were identified. The overall age-standardized incidence rates were 8.4/100,000 standardized population/year (95% CI 7.4-9.3) for Cracow province, 6.5/100,000/year (95% CI 5.6-7.4) for Wroclaw province and 7.9/100,000/year (95% CI 6.9-8.8) for Warsaw. A significant trend of increase for children aged 0-14 years was found in the three cities. The analysis of the trend in age subgroups showed a significant increase in incidence in all three age subgroups in Warsaw and Cracow province (0-4 year-old children, p <0.05; 5-9 year-olds, p <0.001 in Cracow province, p <0.05 in Warsaw, and in 10-14 year-olds, p <0.05 in Cracow province, p <0.005 in Warsaw). In the Wroclaw province a significant increase was observed in children aged 0-4 years (p <0.05) and 5-9 years (p <0.001). In children aged 10-14 years the increase was not statistically significant. The results of our study showed that the incidence of type 1 DM in children is rising. A similar phenomenon is occurring in many other countries. The greatest increase of incidence was observed in the 5-9 year-old subgroup of children in Cracow and Wroclaw provinces and in children aged 10-14 years in Warsaw. The incidence rates in excess of 9.0/100,000 per year observed since 1996 have placed Poland in the group of countries with low to medium incidence.
Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Adolescent , Child , Child, Preschool , Female , Humans , Incidence , Male , Poland/epidemiology , Prospective Studies , Rural Population , Urban PopulationABSTRACT
The increase in diabetes type 1 incidence observed in various centers in Poland and the need for a centralized study covering large population have resulted in the construction of a standardized registry of type 1 diabetes in 1998 within the Polish Multicenter Study in Diabetes Epidemiology. The aim of the study was to present the incidence rates of type 1 diabetes in the age group 0-14 in 7 distinct regions of Poland (Krakow, Wroclaw, Warsaw, Bialystok, Poznan, Rzeszow and Olsztyn centers) with over 30% of the Polish population at risk in 1998 and 1999. The data for the standardized registry were obtained prospectively from paediatric hospital wards and diabetes outpatient units. The incidence rates calculated in 1998 showed the highest value of 14.6 and 14.5/100,000 for Olsztyn and Warsaw, and the lowest (8.4/100,000) for Poznan center. In 1999 the highest value of 14.7/100,000 was noted in Krakow and the lowest (9.3/100,000) in Poznan center. The differences in diabetes type 1 incidence rates between age groups 0-4, 5-9 and 10-14 were found to be significant (p < 0.0005) and were also significant when incidence rates were compared between males and females in these age groups in the whole study area in 1998-1999 (p = 0.002 and p = 0.015 respectively).
Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Adolescent , Age Distribution , Age Factors , Chi-Square Distribution , Child , Child, Preschool , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Poland/epidemiology , Prevalence , Prospective Studies , Registries , Risk Factors , Sex Distribution , Sex FactorsSubject(s)
C-Peptide/blood , Diabetes Mellitus/physiopathology , Peptides/blood , Adolescent , Adult , Arginine , Child , Child, Preschool , Diabetes Mellitus/drug therapy , Female , Humans , Insulin/therapeutic use , Islets of Langerhans/physiopathology , Male , Pancreatic Function Tests , Stimulation, Chemical , Time FactorsABSTRACT
The secretion of insulin, glucagon and growth hormone was determined in the serum of patients with recently diagnosed juvenile-type diabetes (10 patients) during stimulation by intravenous infusion of L-arginine and was compared with the results found in a group of five healthy persons. The value of the insulinemia was significantly lower in the diabetics as compared with the healthy controls. Serum glucagon levels were higher in all diabetics when fasting and after L-arginine administration as compared with the controls but a significant difference was observed only at the peck of secretion (5 min after L-arginine administration). Growth hormone concentration was slightly higher in the diabetics after secretory stimulation than in the controls, particularly at the peak of secretion (30 and 45 min) but the difference was statistically no significant.
