Lu C-L, Shen H-N, Chen H-F, Li C-Y
Department of Medical Research, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan; Department and Institute of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan.
Diabet Med. 2014 Jun;31(6):666-73. doi: 10.1111/dme.12407. Epub 2014 Mar 5.
To report the annual incidence rate and the socio-demographic and clinical characteristics of childhood Type 1 diabetes in Taiwan in the period 2003-2008.
A total of 1306 incident cases of childhood (0-14 years) Type 1 diabetes were identified from Taiwan's National Health Insurance claim datasets from the period 2003-2008. The temporal trend of the incidence rate of Type 1 diabetes and the features of hospitalizations in the first year after diagnosis were investigated. The associations of patient characteristics, child population density and the urbanization level of the residential areas with the risk of Type 1 diabetes were assessed using Poisson regression analysis.
The annual incidence rate was stable, irrespective of age and gender, with a mean annual incidence rate of 5.3 per 100 000 children. Girls were more likely than boys to develop Type 1 diabetes (6.0 vs 4.7 per 100 000 children) and the incidence rate increased with age. There was no apparent geographic variation in the incidence rates. Despite the 60% decrease in the rate of admission (from 11.0 to 5.8%) over the study period, ketoacidosis remained the major diabetes complication leading to admission for childhood Type 1 diabetes. The multivariate analysis suggested that female gender and older age were significant predictors of the incidence of Type 1 diabetes, whereas the population density of children and the urbanization levels of the residential areas were not.
Girls and older children should receive particular attention when formulating preventive strategies targeting Type 1 diabetes. Additionally, clinicians should still carefully optimize the management of children with Type 1 diabetes to further reduce the occurrence of ketoacidosis.
报告2003 - 2008年台湾地区儿童1型糖尿病的年发病率以及社会人口统计学和临床特征。
从2003 - 2008年台湾地区国民健康保险理赔数据集里识别出1306例儿童（0 - 14岁）1型糖尿病新发病例。研究了1型糖尿病发病率的时间趋势以及确诊后第一年的住院特征。使用泊松回归分析评估患者特征、儿童人口密度和居住地区城市化水平与1型糖尿病风险之间的关联。
年发病率稳定，与年龄和性别无关，平均年发病率为每10万名儿童5.3例。女孩比男孩更易患1型糖尿病（每10万名儿童中分别为6.0例和4.7例），且发病率随年龄增长而升高。发病率无明显地理差异。尽管在研究期间入院率下降了60%（从11.0%降至5.8%），但酮症酸中毒仍是导致儿童1型糖尿病入院的主要糖尿病并发症。多变量分析表明，女性和年龄较大是1型糖尿病发病率的显著预测因素，而儿童人口密度和居住地区城市化水平则不是。
在制定针对1型糖尿病的预防策略时，女孩和年龄较大的儿童应受到特别关注。此外，临床医生仍应仔细优化对1型糖尿病儿童的管理，以进一步减少酮症酸中毒的发生。
