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Type 1 and type 2 diabetes mellitus in children 

Type 1 and type 2 diabetes mellitus in children
Chapter:
Type 1 and type 2 diabetes mellitus in children
Author(s):

Krystyna A. Matyka

DOI:
10.1093/med/9780199235292.003.1430
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date: 17 November 2019

The global incidence of type 1 diabetes mellitus in childhood is increasing, with the greatest rise occurring in younger children (under five years of age). Data suggest that the annual rise is of the order of 3% and that changes in incidence figures are also occurring in those countries that have traditionally had low incidence rates of type 1 diabetes. Data collated for the IDF Diabetes Atlas suggest that one-quarter of all children with type 1 diabetes reside in Southeast Asia and more than a fifth are from Europe. However, data ascertainment from developing countries in sub-Saharan Africa and South America can be poor, so these figures may be misleading. Table 13.4.7.1 summarizes the data from 2007 examining incidence and prevalence by region (where available) (1).

The reasons for the increasing prevalence of childhood diabetes are unclear. Improvements in diagnosis and management in developing countries may account for some of the increasing prevalence in these parts of the world. Some studies also suggest that the rise in type 1 diabetes may reflect the rise in childhood obesity, and that type 1 and type 2 diabetes may represent points on a spectrum of disease: the so-called ‘accelerator hypothesis’. Type 2 diabetes is also becoming common in children, associated with increasing rates of obesity and physical inertia. Whatever the causes, the challenges of the management of diabetes in children and young people are significant. Audit data highlight significant problems, with many children experiencing poor glycaemic control (2). This chapter aims to explore the special considerations of diabetes in the young.

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