在 2017-2022 年期间，斯普斯卡共和国儿童 1 型糖尿病和酮症酸中毒发病率不断上升的证据，特别关注 COVID-19 全球大流行期间。
Evidence of increasing incidence of type 1 diabetes and ketoacidosis among children in the Republic of Srpska in period 2017-2022 with special focus on COVID-19 global pandemic years.
机构信息
Pediatric Clinic, University Clinical Center of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
Department of Pediatric, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
出版信息
Front Public Health. 2023 Sep 6;11:1264099. doi: 10.3389/fpubh.2023.1264099. eCollection 2023.
BACKGROUND AND OBJECTIVES
Primary focus of the research was to determine the incidence of type 1 diabetes mellitus in the period from 2017 to 2022, and whether COVID-19 had an impact on the increase in the number of newly diagnosed children with diabetes type 1 under the age of 15 in the Republic of Srpska (Bosnia and Herzegovina). In the period 2001-2016 the incidence of type 1 diabetes mellitus was 11/100,000, with an annual increasing rate of 14.2%.
METHODS
Available data from pediatric endocrinology clinics, in the Republic of Srpska, on the number of newly diagnosed patients with diabetes mellitus in the period from January 1, 2017 until December 31, 2022 were used. A retrospective analysis was performed, and the capture-recapture method was used for the final assessment, and the obtained result corresponds to about 99% of the population.
RESULTS
The total number of children in the group of 0-14 years of age diagnosed with type 1 diabetes mellitus in this period was 183, of which 96 (52.46%) were boys, and 87 (47.54%) were girls. The average age at which diabetes mellitus was diagnosed was 8.3 ± 3.9 years. Average incidence of diabetes in the period 2017-2022 was 19/100,000 (95% CI 13.1-25.0). The highest incidence was 28.7/100,000 in 2020, the first year of the global COVID-19 pandemic. Out of a total of 183 newly diagnosed cases in the period 2017-2022, 73 (39.9%) were diagnosed with ketoacidosis upon admission. The largest number of newly diagnosed children was recorded in the group of children aged 10-14 years.
CONCLUSION
In the last 6 years, there has been a significant increase in the incidence of type 1 diabetes mellitus in children under the age of 15. With an incidence of 19.4/100,000 in the Republic of Srpska, we entered the group of countries with high-risk for diabetes. Further steps must focus on the education of the entire society in order to recognize the symptoms of the disease in time and prevent the occurrence of ketoacidosis, which could significantly reduce the burden on health systems, especially in times of global pandemics, such as the COVID-19 pandemic.
背景与目的
本研究的主要目的是确定 2017 年至 2022 年期间 1 型糖尿病的发病率，以及 COVID-19 是否对 15 岁以下新诊断为 1 型糖尿病的儿童人数增加产生影响。在 2001-2016 年期间，1 型糖尿病的发病率为 11/100,000，年增长率为 14.2%。
方法
本研究使用了 2017 年 1 月 1 日至 2022 年 12 月 31 日期间，来自斯普斯卡共和国儿科内分泌科新诊断为糖尿病的患者数量的可用数据。进行了回顾性分析，并使用捕获-再捕获法进行了最终评估，结果对应于约 99%的人口。
结果
在此期间，0-14 岁儿童中被诊断为 1 型糖尿病的总人数为 183 人，其中 96 人（52.46%）为男孩，87 人（47.54%）为女孩。糖尿病诊断的平均年龄为 8.3±3.9 岁。2017-2022 年期间的平均发病率为 19/100,000（95%CI 13.1-25.0）。发病率最高的是 2020 年，即全球 COVID-19 大流行的第一年，为 28.7/100,000。在 2017-2022 年期间总共新诊断的 183 例病例中，73 例（39.9%）入院时诊断为酮症酸中毒。新诊断的儿童数量最多的是 10-14 岁年龄组。
结论
在过去的 6 年中，15 岁以下儿童 1 型糖尿病的发病率显著增加。在斯普斯卡共和国，发病率为 19.4/100,000，我们已进入糖尿病高危国家之列。进一步的措施必须侧重于全社会的教育，以便及时识别疾病的症状并预防酮症酸中毒的发生，这可以显著减轻卫生系统的负担，尤其是在全球大流行（如 COVID-19 大流行）期间。
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