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. 2022 Jun 15:10:888370.
doi: 10.3389/fped.2022.888370. eCollection 2022.

Clinical Incidence and Characteristics of Newly Diagnosed Type 1 Diabetes in Chinese Children and Adolescents: A Nationwide Registry Study of 34 Medical Centers

Guo-Hua Li  1 , Ke Huang  1 , Guan-Ping Dong  1 , Jian-Wei Zhang  2 , Chun-Xiu Gong  3 , Fei-Hong Luo  4 , Xiao-Ping Luo  5 , Chun-Lin Wang  6 , Min Zhu  7 , Pin Li  8 , Ling Wang  9 , Jun-Fen Fu  1 ; T1DM China Study Group for Children Adolescents
Affiliations

Clinical Incidence and Characteristics of Newly Diagnosed Type 1 Diabetes in Chinese Children and Adolescents: A Nationwide Registry Study of 34 Medical Centers

Guo-Hua Li et al. Front Pediatr. .

Abstract

Objective: To investigate the clinical incidence and characteristics of type 1 diabetes mellitus (T1DM) of children and adolescents at the time of initial diagnosis in China.

Methods: Data on all pediatric patients with newly diagnosed T1DM were retrospectively collected from 34 medical centers in 25 major cities in China from January 2015 to January 2020. Patients were classified into three age groups: <5 years, 5 to <10 years, and ≥10 years of age. The same patient population was also categorized into diabetic ketoacidosis (DKA) and non-DKA groups based on clinical criteria.

Results: The mean annual clinical incidence of T1DM was 3.16/100,000 from the years 2015 to 2019. A total of 6,544 patients with newly diagnosed T1DM aged 0-16 years (median 7.84 ± 3.8) were studied [ages <5 years (29.3%), 5 to <10 years (38.7%), and ≥10 years (32%)], 52.4% of them were women. In total, 90.5% of the cases were occurred in individuals without a family history. Patients had lower C-peptide (CP) and body mass index (BMI) z scores when compared with healthy children, 41.8% of them had measurable T1DM-related antibodies and 52.7% had DKA. Among all three age groups, the <5 years group had the lowest BMI z score, CP, and glycated hemoglobin (HbA1c) on average, while it had the highest incidence rate of DKA (56.9%). Compared to the non-DKA group, the DKA group was significantly younger, with a lower BMI z score and CP, higher antibody positive rate, HbA1c, and the rate of insulin pump therapy.

Conclusion: The clinical incidence of T1DM in children and adolescents in China was 3.16/100,000. Patients with DKA at the first diagnosis of T1DM have a worse β-cell function. Public health measures for the prevention and treatment of T1DM should focus on preschoolers (aged <5 years) in particular, considering the severity and the highest frequency of DKA in this age group. More efforts should be dedicated to early screening and diagnosis of the T1DM.

Keywords: children and adolescences; diabetic ketoacidosis; incidence; type 1 diabetes; β-cell function.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Clinical incidence of T1DM in children and adolescents in China.
Figure 2
Figure 2
Clinical incidence of T1DM in children and adolescents in China stratified by geographical region.
Figure 3
Figure 3
Indices of insulin secretion (CP) and HbA1c in the participants. Panels (A,B): Age groups. Panels (C,D): DKA and non-DKA groups.
Figure 4
Figure 4
Percentage of family history positive in DKA and non-DKA groups respectively.
See this image and copyright information in PMC

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