Ethnic differences in the incidence of childhood IDDM in Israel (1965-1993). Marked increase since 1985, especially in Yemenite Jews.

OBJECTIVE: To establish the changes in the incidence of childhood IDDM during the years 1965-1993 in the different ethnic groups in Israel. RESEARCH DESIGN AND METHODS: A whole-country register of childhood IDDM (0-17 years) was started in Israel in 1965. Onset of IDDM was considered to be the date of first insulin injection. The data were collected from all outpatient clinics and hospitals. Ascertainment is estimated to be over 95%. RESULTS: A total of 1,868 patients were registered for a period of 28 years. Marked differences were found between ethnic groups. The highest incidence was among the Yemenite Jews, who reached an incidence of 18.5/10(5), followed by Ashkenazi Jews (10.0/10(5)), non-Ashkenazi Jews, except Yemenites (7.3/10(5)), and Arabs (2.9/10(5)). In addition, it was found that in all Jewish subgroups, in contrast with the Arabs, there was a marked increase in incidence after 1985. CONCLUSIONS: Israel is a country with low, intermediate, and high incidence of childhood IDDM. The interethnic differences in incidence are probably due to genetic factors. However, the significant increase in incidence since 1985 in the Jewish population is ascribed to thus far unidentified environmental factors. It is hypothesized that the marked increase in IDDM is due to environmental factors linked to changes in affluence and lifestyle. These may also explain the difference in incidence between the Jewish and Arab populations, the latter living more in rural areas and leading a more traditional lifestyle.

Four years experience with the microcomputer system "Diacon" in the treatment and education of diabetes.

The use of a user-friendly microcomputer system "DIACON" which stores, analyses and displays blood glucose, details of the nutrition intake, insulin dose and other details relevant to diabetes management is described. This system tested for over four years in more than 100 diabetic patients has proven to be a useful educational and therapeutic tool.

The use of computers in the control of diabetes in children and adolescents.

The actual and possible applications of computers in diabetes management are manifold. There are programs for medical information, storage and analysis, pertinent literature search, artificial intelligence, algorithms assisting the patient to adjust the insulin dose and education programs. One very useful microcomputer program DIACON is described in detail. This program is both an educational and therapeutic tool in that it increases both knowledge and long term compliance; it stores, displays and analyses the large amount of self blood glucose monitoring (SBGM) data, HbA1, C-peptide, nutritional data, sport activities and insulin dose. It is concluded that the use of computers in the management of diabetes has become a necessity, but despite the programs of artificial intelligence and algorithms, it is critical that the physician retains the ultimate responsibility for diagnostic and therapeutic strategies.