Incidence of type 1 diabetes in children (0-14 years) in Benghazi Libya (1991-2000).

BACKGROUND: Incidence of Type 1 diabetes in 0-14 year olds in Benghazi (Libya) during the period 1981-1990 was 7.0/10 5. The aim of this study is to report the incidence of Type 1 diabetes in 0-14 year olds in Benghazi Libya during the period 1991-2000. METHODS: Incidence data are based on prospective registration of Type 1 diabetes new cases for the period 1991-2000 in Type 1 register. RESULTS: A total of 276 (males 117, females 159) Type 1 diabetes new cases 0-14 years of age were identified during the period 1.01.1991-31.12.2000. Completeness of ascertainment was 100%. The average annual incidence per year was 7.8/100,000 population (95% CI 6.91-8.78). The standardized incidence rate (World standard) was 8.3/100,000 (95% CI 7.36-9.35). There was excess risk for females (9.1 95% CI 7.77-10.65) versus males (6.6 95% CI 5.45-7.89) (p<0.001). No significant temporal trend was observed, yet there was an increase in incidence rate over that reported for the period 1981-1990 (7.8 vs 7.0). Seasonal variation in incidence was significant. CONCLUSION: It was concluded that the incidence of Type 1 diabetes in Benghazi is in the middle of the worldwide range close to the incidence in Mediterranean countries.

Prevalence of diabetes mellitus and impaired glucose tolerance in Benghazi Libya.

OBJECTIVES: To assess, by a house to house study, the prevalence of diabetes, impaired glucose tolerance (IGT) and their associated risk factors in Benghazi, Libya using 75 gram oral glucose tolerance test (OGTT) and ADA 1997 and WHO 1998 diagnostic criteria. MATERIAL AND METHODS: A multistage cluster sampling was used to select the study population. A total of 314 men and 554 women underwent a standard 75 grams OGTT. The response rate was 77.7% for males and 89.2% for females. RESULTS: The overall prevalence of IGT was 8.5% (95% confidence interval (CI) 5.8 - 11.3) (men 8.6% 95% CI 7.7-9.6, women 8.5% 95% CI 5.0 -11.9), and that of diabetes was 14.1% (95% CI 10.9-17.1) (men 16.3% 95% CI 14.5-18.3 women 13.0% 95% CI 10.0 - 16.1). Diabetes was present in 19.4% (95% CI 15.4-20.5) (men 22.7% 95% CI 20.2-25.4, women 17.6% 95% CI 14.1-19.1) in 30-64 years age range. Prevalence of diabetes was slightly higher in urban than in rural areas (14.5% vs 13.5%). The prevalence of newly diagnosed diabetes in urban and rural areas were 3.6% and 7.3% respectively and that of known diabetes were 10.9% and 6.3% respectively. Associated risk factors with diabetes and IGT were age, family history of diabetes, hypertension, BMI, WHR and serum cholesterol. CONCLUSION: Diabetes is emerging as an important public health problem in Libya and should rank very high in the priority list of health planners.

Epidemiological and clinical patterns of diabetes mellitus in Benghazi, Libyan Arab Jamahiriya.

The clinical characteristics and prevalence of non-insulin-dependent diabetes mellitus (NIDDM) diagnosed in Benghazi are reported. Data were based on the analysis of records for the period 1981 to 1990. A total of 8922 NIDDM cases (4081 males, 4841 females) were registered during the study period. The overall prevalence rate of NIDDM was 0.19%; it was significantly higher in females (0.21%) than males (0.17%) (P < 0.01). The prevalence rate in patients aged > or = 20 years was 3.8% and was significantly higher in females (4.7%) than in males (2.9%) (P < 0.01). Prevalence rates increased with each higher age group and peaked in the 50-54 years age group. Prevalence of hypertension was 22.5% and prevalence of overweight was 59.4%. The most common complications of diabetes were neuropathy (45.7%), retinopathy (30.5%) and nephropathy (25.2%).

Epidemiological and clinical patterns of diabetes mellitus in Benghazi, Libyan Arab Jamahiriya

The clinical characteristics and prevalence of non-insulin-dependent diabetes mellitus [NIDDM] diagnosed in Benghazi are reported. Data were based on the analysis of records for the period 1981 to 1990. A total of 8922 NIDDM cases [4081 males, 4841 females] were registered during the study period. The overall prevalence rate of NIDDM was 0.19%; it was significantly higher in females [0.21%] than males [0.17%] [P < 0.01]. The prevalence rate in patients aged > or = 20 years was 3.8% and was significantly higher in females [4.7%] than in males [2.9%] [P < 0.01]. Prevalence rates increased with each higher age group and peaked in the 50-54 years age group. Prevalence of hypertension was 22.5% and prevalence of overweight was 59.4%. The most common complications of diabetes were neuropathy [45.7%], retinopathy [30.5%] and nephropathy [25.2%]

Incidence of insulin-dependent diabetes mellitus in Benghazi, Libya (1991-1995).

This report concerns the incidence rate of insulin-dependent diabetes mellitus (IDDM) in the 0-14 year age group in Benghazi, Libya. Incidence data are based on prospective registration of patients as part of the WHO Diamond Project from 1991 to 1995. A total of 126 IDDM incident cases (73 girls, 53 boys) were identified during this 5-year period. All patients were Libyan Arab Benghazi residents. Case ascertainment was 100%. The overall yearly incidence was 8.1 cases/100,000 population (95%, CI 6.8-9.7). Incidence was slightly higher in girls (9.5, CI 7.5-12.0) than in boys (6.7, CI 5.1-8.8). Incidence rates increased steadily with age in both sexes and were slightly higher than those reported for Benghazi during the period 1981 to 1990 (girls 7.8, boys 6.3, both sexes 7.0). Annual variation of incidence was not significant, whereas seasonality of onset was significant (P < 0.05). The study shows that IDDM is as frequent in Libya as in other Mediterranean countries.

Incidence of insulin-dependent diabetes (IDDM) and non-insulin-dependent diabetes (NIDDM) (0-34 years at onset) in Benghazi, Libya.

The incidence of insulin-dependent diabetes (IDDM) and non-insulin-dependent diabetes (NIDDM) in Benghazi, Libya in the < 35-year age group during the period 1981-1990 are reported. Incidence data for IDDM were based on prospective registration of patients while incidence data for NIDDM were based on analysis of files. Case ascertainment of IDDM cases was estimated to be > 95%. Incidence of total diabetes (IDDM and NIDDM) (per 100000 population) was significantly higher in females (43.8; 95% confidence Interval (CI) 40.6-47.2) than in males (28.9, 26.6-31.3) (P < 0.001). The overall incidence rates of IDDM and NIDDM were 9.0 (CI, 8.1-10.0) and 27.3 (CI, 25.4-28.2), respectively. Rates of IDDM were 9.4 (CI, 8.1-10.9) among males and 8.5 (CI, 7.3-10.0) among females. Rates of NIDDM were 19.6 (CI, 18.1-22.2) among males and 35.3 (CI, 32.4-37.8) among females. IDDM patients showed a female predominance in the 0- to 14-year age range (P > 0.05) and a male predominance in the 15- to 34-year age range (P > 0.05). NIDDM showed equal incidence in males and females in the 0- to 14-year age range and twofold higher incidence in females than in males in the 15- to 34-year age group (P < 0.001). Yearly variation and seasonality of onset were not significant in IDDM cases (P > 0.05). Fifty-six percent of NIDDM cases were obese compared to only 6% of IDDM cases. The study revealed that diabetes mellitus is a common chronic disease in children and young Libyan Arabs. It has shown that NIDDM in Benghazi is twofold higher in females than in males in the 15- to 34-year age group. It has also shown that age per se is not a reliable criterion for the classification of diabetes into IDDM and NIDDM.

Ten-year incidence (1981-90) of insulin-dependent diabetes in the 0-29-year-old age group in Benghazi, Libya.

The incidence of Type 1 diabetes in Benghazi, Libya in the < 30-years age group was prospectively studied during the period 1981-1990. A total of 161 male and 150 female new cases were diagnosed during the study period. Case ascertainment was estimated to be 100%. The overall incidence rate (per 100,000) was 8.8 (95% C.I., 7.8-9.9). Rates were 8.9 (95% C.I., 7.6-10.4 among males and 8.6 (95% C.I., 7.3-10.1) among females). A female predominance in the 0-14-years age range and a male predominance in the 15-29-years age range were observed (P > 0.05). The age-specific incidence rate increased steadily from 2.2 (95% C.I., 1.4-3.4) in the 0-4-years age group to 16.9 (95% C.I., 13.6-21.0) in the 15-19-years age group and declined afterwards. Age adjusted incidence rates in the 0-14- and 15-29-years age ranges were 7.0 (95% C.I., 6.0-8.2) and 11.9 (95% C.I., 10.0-14.0), respectively. Yearly variation and seasonality of onset were not significant. The study revealed a relatively high incidence rate of Type 1 diabetes among Libyan Arabs aged less than 30 years.

Incidence and prevalence of type 1 diabetes in children and adolescents in Benghazi, Libya.

The mean annual incidence rates of Type 1 diabetes mellitus in Arab children and adolescents in Benghazi, Libya were assessed as based on prospective registration of patients during the period 1981-1990. Results showed an annual incidence (per 100,000) of 7.0 (6.0-8.2) (males 6.3(5.0-7.9) females 7.8(6.3-9.7)) in 0-14 year olds and 8.8(7.8-10.0) (males 8.3(6.9-10.0), females 9.2(7.7-11.0)) in 0-19 year olds. There were no significant differences between males and females or between season of onset. The commonest age of onset was 15-19 years. Annual variations were significant in the 0-14 years age group (p < 0.001) and non-significant in the 0-19 years age group. In 1981 the age adjusted prevalence rates of Type 1 patients (per 100,000) were 23.5 (17.1-31.5) (males 21.2(13.1-32.3), females 25.9(16.8-38.3)) in 0-14 year olds and 36.2(29.1-45.1) (males 31.4(22.2-43.2), females 41.0(30.2-54.5)) in 0-19 year olds. In 1990 the prevalence rates had increased to 37.3(30.5-45.5) (males 40.7(30.8-53.3), females 33.8 (24.6-45.3)) in 0-14 year olds and 59.5(51.6-58.5) (males 60.3(49.3-73.6), females 58.6 (47.7-72.1)) in 0-19 year olds. Increase in prevalence rates was significant in both sexes and in both age groups (p < 0.001). Increase in prevalence rates in girls in 1981 and in boys in 1990 were not significant. It is concluded that Type 1 diabetes is a common chronic disease of children and adolescents in Benghazi, Libya.

Outcome of pregnant diabetic patients in Benghazi (Libya) from 1984 to 1991.

During the period from 1 June 1984 to 1 June 1991, 988 pregnant diabetic patients were treated by a team of physicians and obstetricians in Benghazi Diabetic Clinic. Twelve patients were insulin-dependent (type 1) and 976 patients were non-insulin-dependent (type 2). Ninety patients were diagnosed for the first time during pregnancy. Thirty-nine patients defaulted. Eight hundred and seventy-six patients were treated with insulin and 112 patients were controlled by diet. The average daily insulin dose was 40.12 units. The majority, 64.5%, delivered vaginally and 35.5% by caesarean section. Rates of abortion, intra-uterine death and still birth were 7.99%, 3.28% and 2.6%, respectively. The mean birth weight was 3.78 +/- 0.89 kg. Congenital anomalies of infants were 3.4%. Perinatal morality was 11.44%. Poor metabolic control has been associated with increased rates of abortion, intra-uterine death and congenital anomalies. It was concluded that team approach and multiple insulin injections could improve the outcome of pregnancy in developing countries to near current western standards.

Diabetes mellitus in Benghazi.

The records of 10,772 diabetic patients registered in Benghazi diabetic clinic during the period 1969-1985 were analysed. Non-insulin dependent diabetes mellitus (NIDDM or type II) accounted for 97.8% of patients. Of the whole clinic population 77.2% were below 40 years of age. The disease started below the age of 20 years in 1.9%. Male to female sex ratio was 1:1.2. Family history of diabetes was positive in 23.77%. Sixty-nine per cent of patients were obese. Patients presented with symptoms suggestive of diabetes mellitus in 79.7% of cases.