Clinical and laboratory features of type 1 diabetic children at the time of diagnosis.

The French incidence study has registered all new cases of Type 1 diabetic children under 20 years of age, from a population of 2.32 million, in an exhaustive and prospective manner. Three hundred and forty cases were identified between 1 January 1988 and 31 December 1989, yielding a mean annual incidence rate 7.3 per 10(5). The lowest rate was observed in the youngest age group (0-4 yr: 4.1 per 10(5)) and the highest around pubertal development (10-14 yr: 11.5 per 10(5)). Details of the previous personal and family history, and the clinical and biological pictures of the disease at diagnosis were recorded. Almost 8 per cent of the children had a first-degree relative with Type 1 diabetes. Polyuria, weight loss, fatigue and abdominal pain were the most frequently reported symptoms, which were of median duration 4.4 months. Mean weight loss before diagnosis was 9.4 +/- 6.8 (+/- SD)% of body weight and was not significantly related to age. Ketonuria was detected in 83.8 per cent and acidosis (total CO2 less than or equal to 18 mmol l-1, if measured) in 48 per cent of the cases. Ketonuria and acidosis were significantly more frequent in the younger age group than in the rest of the group (p less than 0.001).

[Incidence of insulin-dependent diabetes occurring before 20 years of age in France]. / Incidence du diabète insulinodépendant survenant avant l'âge de 20 ans en France.

Incidence rates of insulin dependent diabetes mellitus (IDDM) are distributed over Europe along a North to South gradient where the values observed in Finland are 7-fold greater than in the South. According to previous data, France represented the bottom of this gradient. A survey in 1988 and 1989 was conducted in order to record all newly diagnosed diabetic children under 20 years of age, in 4 French regions: Aquitaine, Lorraine, lower Normandie, upper Normandie. The mean annual incidence rate was 7.3/10(5), without any significant geographical variation. Age-specific incidence rates indicated two peaks: one in the younger age group and the other around puberty, already described in most incidence studies. The study confirms that France is a country with one of the lowest incidence rate in Europe. It also suggests that incidence has increased over the past decades as in other countries.

Incidence of juvenile type 1 (insulin-dependent) diabetes mellitus in France.

The incidence rate of juvenile Type 1 (insulin-dependent) diabetes in France was reported as the lowest in Europe 13 years ago, but during the recent years increasing rates have been observed in different European countries. A prospective programme has been designed to study the incidence rate of Type 1 diabetes in patients up to 20 years of age in four regions located in the north and south of France (population less than 20 years = 2.31 million inhabitants; 15% of the French population). All cases were independently identified by four specially trained research assistants through hospital admission files, paediatricians, diabetologists and general practitioners. A specific questionnaire was filled out for each newly diagnosed case. Degree of ascertainment was 96% with the data from Sécurité Sociale, the French National Health Insurance. In 1988, 166 cases of juvenile Type 1 diabetes were identified. The incidence rate was 7.17 cases per 10(5) children (95% confidence interval = 6.1-8.2/10(5). The values were not statistically different among the four regions. Age specific incidence rates were as follows: 0-4 years = 3.8; 5-9 years = 8.0; 10-14 years = 9.7 and 15-19 years = 7.3/10(5). Sex ratio was 1.2 (male/female). These data indicate that incidence of juvenile Type 1 diabetes in France was higher in 1988 than previously reported but remains lower than in Northern Europe. This is consistent with the concept of a north to south gradient of the disease.