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Aktuelle
Informationen und News
zum Thema Zuckerkrankheit / Diabetes mellitus
Quelle:
THE LANCET: Press Release - EMBARGO: Wednesday 27 May 2009
Die Häufigkeit von Typ-I-Diabetes wird
sich bei Kindern vermutlich bis zum Jahr 2020 verdoppeln
TYPE 1 DIABETES IN CHILDREN UNDER FIVE TO DOUBLE
BY 2020
Cases
of type 1 diabetes in children under five years across Europe will
double by 2020 (from 2005 levels) if present trends continue. Numbers
in children older than five will also increase substantially. The
findings are discussed in an Article published Online First and
in an upcoming edition of The Lancet, written by Dr Chris Patterson,
Queen’s University, Belfast, UK, and Prof Gyula Soltész,
Pécs University, Pécs, Hungary, and colleagues.
Type
1 diabetes is caused by insulin deficiency (and thus must be treated
with insulin injections), whereas type 2 diabetes is caused by reduced
insulin sensitivity along with some insulin deficiency. In the general
population, type 1 diabetes cases represent only 10% of total diabetes
cases. However among children the numbers of cases of type 1 diabetes
is higher than type 2 in most countries. To predict the future burden
of type 1 diabetes, the authors analysed diabetes data from 20 centres
in 17 European countries, which had registered 29311 cases of type
1 diabetes during the period 1989-2003.
The
researchers found that the overall increase in incidence of type
1 diabetes was 3.9% per year; while the annual increase in the 0—4
years age group was 5.4%, with a 4.3% rise in the 5—9 years
age group, and a 2.9% rise in 10—14—year-olds. There were
estimated to have been approximately 15,000 new cases in Europe
in 2005, divided among the 0—4 years, 5—9 years, and 10—14
in the ratio 24%, 37% and 34% respectively. A total of 24,400 new
cases is predicted in 2020, with a doubling in the number of cases
in children aged under 5 years and a more even distribution across
age groups than at present (29%, 37%, and 34% respectively). If
present trends continue, the total number of cases (new and existing)
in European children under 15 years is predicted to rise from 94,000
in 2005 to 160,000 in 2020—a 70% increase.
The
changes over time are so rapid, say the authors, that they clearly
cannot be because of genetic factors alone. They discuss modern
lifestyle habits as possible contributory factors, such as increased
weight and height development and increased caesarean section births.
The higher increases are seen in Eastern Europe, where lifestyle
habits are also changing more rapidly than in the richer European
countries.
The
authors conclude: “The predicted rise in childhood type 1 diabetes
in Europe during the next 20 years, and the raised proportion of
cases diagnosed at younger ages than were before, could result in
more cases presenting with ketoacidosis and needing hospital admission.
More patients with severe diabetes complications presenting at younger
ages than before are also likely, and appropriate care from diagnosis,
and maintenance of good metabolic control are crucial for delay
or prevention of these adverse complications. In the absence of
any effective means to prevent type 1 diabetes, European countries
need to ensure appropriate planning of services and that resources
are in place to provide high-quality care for the increased numbers
of children who will be diagnosed with diabetes in future years.”
In
an accompanying Comment, Dr Dana Dabelea, Colorado School of Public
Health, University of Colorado, Denver, CO, USA, says the findings
from this and other studies suggest ‘that the incidence of
type 1 diabetes is increasing even faster than before, pointing
towards harmful changes in the environment in which contemporary
children live’. She also discusses the findings specific to
children under 5, and the concerns that younger age of onset of
type 1 diabetes is usually associated with more acute symptoms.
The consequences of longer exposure to altered metabolism due to
diabetes and the increasing economic costs of the disease are also
looked at.
She
concludes: “It is imperative that efforts directed at surveillance
of diabetes in young people continue and expand, not only to understand
its complex aetiology, but also because of its increasing public
health importance.”
Dr
Chris Patterson, Queen’s University, Belfast, UK T) +44 (0)28
9063 2688 E) c.patterson@qub.ac.uk
Prof
Gyula Soltész, Pécs University, Pécs, Hungary
T) +36 72 535-900
E) gyula.soltesz@aok.pte.hu
Dr
Dana Dabelea, Colorado School of Public Health, University of Colorado,
Denver, CO, USA E) Dana.Dabelea@ucdenver.edu
For
full Article and Comment, see: http://press.thelancet.com/childtype1.pdf
Note
to editors: *ketoacidosis: this is a common complication of type
1 diabetes in which the liver breaks down fats and proteins to provide
energy in an unregulated fashion, leading to such a high concentration
of ketone acids in the blood that the acidity of the blood is increased.
Severe ketoacidosis is potentially life threatening if not treated
promptly.
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