Type 1 Diabetes and Where You’re At
By: Cassidy Myhre
The incidence of childhood onset diabetes is increasing across the globe. Although the exact cause of Type 1 Diabetes (T1D) still remains unknown, evidence suggests there is likely geographical variation in the incidence of childhood T1D due to genetic predisposition and environmental factors.
The SWEET experience, a study investigating worldwide differences in childhood diabetes among five regions, found:
- Adjusted HbA1c means ranged from 7.8% in Europe to 9.5% in Asia/Middle East/Africa.
- Mean daily insulin dose ranged from 0.8 units/kg in Europe and Australia/New Zealand to 1.0 unit/kg in Asia/Middle East/Africa.
- Percentage of pump use was highest in North America (80.7% ) and lowest in South America (4.2%).
- Significant differences between the five regions were also observed with regards to body mass index SD scores, frequency of blood glucose monitoring and presence of severe hypoglycaemia.
Based on the outcomes of the SWEET experience showing significant heterogeneity in diabetes care and outcomes across the five regions, it is crucial to determine the potential risk factors causing these differences. Trends found in another global study suggest variability within large countries is likely due to the distribution of risk genes and environmental exposures such as climate and lifestyle-related factors. An immunogenetic study of T1D in Africa done to identify population differences in the prevalence of T1D found there also may be higher incidence in rural communities due to demographic and socioeconomic characteristics.
The incidence and prevalence rates for T1D in children seem to be rising in most countries around the world, especially in less developed nations with differences in genetic predisposition and lifestyle habits. However, further studies still need to be done in order to establish more reliable trends and determine optimal care for children.