ESPEYB25 13. Global Health for the Paediatric Endocrinologist Diabetes and Diabetes Technology (5 abstracts)
13.15. Estimating the total incidence of type 1 diabetes in children and adolescents aged 0-19 years from 1990 to 2050: a global simulation-based analysis
Ward ZJ , Yeh JM , Reddy CL , Gomber A , Ross C , Rittiphairoj T , Manne-Goehler J , Abdalla AT , Abdullah MA , Ahmed A , Ankotche A , Azad K , Bahendeka S , Baldé N , Jain SM , Kalobu JC , Karekezi C , Kol H , Prasannakumar KM , Leik SK , Mbanya JC , Mbaye MN , Niang B , Paturi VR , Raghupathy P , Ramaiya K , Sethi B , Zabeen B & Atun R
Lancet Diabetes Endocrinol. 2022 Dec;10(12):848-858. PMID: 36372070 doi: 10.1016/S2213-8587(22)00276-5
Brief Summary: This study used a microsimulation model to estimate both the total and diagnosed incidence of type 1 diabetes (T1D) globally and to project childhood T1D incidence indicators from 1990 to 2050, accounting for variability in underlying incidence and health system performance of different countries.
Previous studies of T1D in children have shown large variations in incidence around the world. As this may be due to variations within health systems and issues of underdiagnosis, the authors developed a model to estimate the total and diagnosed incidence of T1D and create future projections for each country. They created a structured model that accounts for trends in health care systems and how this may impact diagnosis of T1D and its mortality. This allows assessment of whether an observed increase in T1D incidence is simply due to increased detection or represents a real increase in underlying incidence. The model takes into account a variety of other factors, synthesizing demographic, epidemiological and clinical data from multiple sources, as well as country specific genetic and environmental factors that may affect T1D incidence.
The model estimated that in 2021 there were 355,900 total new cases of T1D globally among those aged 0-19 years. However, an estimated 56% of these new cases were likely undiagnosed and therefore did not receive care for this lethal disease. Underdiagnosis varies substantially by region with over 95% of new cases correctly diagnosed in western and northern Europe, North America, Australia and New Zealand, but decreasing to 35% in west Africa, south and southeast Asia and Melanesia. Lack of diagnosis is likely due a combination of poor access to care, lack of recognition of sign and symptoms of diabetes and attribution of death to other causes. By 2050, Africa is projected to account for 51% of global new T1D cases per year, with 28% of cases projected to occur in low-income countries and 44% in lower-middle income countries where diagnosis is lowest, implying substantial risks for morbidity and mortality.
The authors point out that efforts to accelerate improvements in diagnosis of T1D will be important as there is a projected increase in total new cases due to both population growth and increase in underlying T1D rates, particularly in Africa.
Volume 22
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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