Department of Endocrinology, Landspitali, The National University Hospital of Iceland, Fossvogur, 108 Reykjavik, Iceland.
Department of Endocrinology, Landspitali, The National University Hospital of Iceland, Fossvogur, 108 Reykjavik, Iceland.
Diabetes Res Clin Pract. 2019 May;151:224-230. doi: 10.1016/j.diabres.2019.04.023. Epub 2019 Apr 18.
Type1 diabetes is generally regarded as an abruptly presenting disease in children without family history. The incidence and prevalence of insulin requiring diabetes in adults is unclear. The aim of this study was to clarify this issue by examining the epidemiology of type 1 diabetes diagnosed in adulthood in a countrýs whole population.
Complete clinical and prescription data were used to identify cases of insulin requiring diabetes in the Icelandic population 18 years and older during the decade preceding February 2013. Health care databases and the insulin reimbursement system allowed for near 100% ascertainment of cases.
Mean age at diagnosis was 32.1 years. The WHO age-adjusted incidence rate was 4.29/100.000 individuals and the point prevalence 0.10%. One fourth of cases were diagnosed after the age of forty. The male-to-female incidence rate ratio was 1.59. Almost 30% of cases presented with diabetic ketoacidosis and 40% had a positive family history.
Type 1 like diabetes commonly presents in adults and family history is not rare. One can expect one case of type 1 diabetes in adults for every two children diagnosed. These results emphasize the need to acknowledge the possibility of absolute insulin deficiency in any newly presenting adult with diabetes.
1 型糖尿病通常被认为是一种在无家族史的儿童中突然出现的疾病。成人中需要胰岛素的糖尿病的发病率和患病率尚不清楚。本研究旨在通过检查一个国家整个人群中成年期诊断的 1 型糖尿病的流行病学来阐明这一问题。
使用完整的临床和处方数据，在 2013 年 2 月之前的十年中，确定冰岛 18 岁及以上人群中需要胰岛素的糖尿病病例。医疗保健数据库和胰岛素报销系统允许几乎 100%确定病例。
诊断时的平均年龄为 32.1 岁。世界卫生组织年龄调整发病率为 4.29/100000 人，时点患病率为 0.10%。四分之一的病例在四十岁以后被诊断。男女发病率比为 1.59。近 30%的病例出现糖尿病酮症酸中毒，40%有阳性家族史。
1 型样糖尿病在成人中常见，且家族史并不罕见。每诊断出两名儿童，就会有一名成人患 1 型糖尿病。这些结果强调了在任何新出现的成年糖尿病患者中都需要认识到绝对胰岛素缺乏的可能性。
