Recent Incidence of Type 1 Diabetes Mellitus in Montenegro: A Shift Toward Younger Age at Disease Onset

Abstract

SUMMARY -In the last several decades, a great number of studies have pointed to a dramatic increase of type 1 diabetes mellitus (T1DM) incidence in the whole world, especially in younger age groups. Therefore, the aim of the study was to assess changes in the age distribution at onset of T1DM in Montenegro children aged <15 years during a 15-year period (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) and analyze the seasonal pattern. Primary case ascertainment was from diabetes register, secondary and tertiary independent data sources were hospital case records and register of children receiving free test stripes in pharmacy. Standardized incidence rates were calculated using the Poisson regression. Case ascertainment was 100% complete using the capture-recapture method. The mean age-standardized incidence was 18.6/100,000 (95% CI: 13.0-24.1) from 2007 to 2011 compared with 13.4/100,000 95% CI, 11.5-15.5) from 1997 to 2006. The incidence of T1DM increased predominantly in younger age groups. Relative increase of incidence per 5-year period was largest in boys aged 0-4 and 5-9 years: 64.7% (95% CI: 20.6-10.7; p=0.004) and 52.8% (95% CI: 16.9-88.8; p=0.004), respectively. Seasonality in monthly case counts of T1DM was apparent. The greatest number of cases were diagnosed during autumn and winter months. In conclusion, the onset of T1DM was found to occur at an ever younger age in Montenegro children. Our results indicated a seasonal pattern of the disease onset.

Evidence for the increase in the incidence of type 1 diabetes in children aged 0-14 years in the Republika Srpska, 2001-2016

“…On the other hand, our results differ from the results recorded in Montenegro, where the incidence is estimated to be significantly higher (17 cases/100,000), and where the incidence is estimated to be more frequent in younger male children, aged up to 4 years. (11) In contrast, in our study boys and girls were equally likely to be diagnosed with T1DM. Furthermore, in Croatia the incidence escalated to 17.23 cases / 100 000 for the 2004 to 2012 period, with the highest incidence rate of 20.0 cases/100,000 for the 10-14 years age group.…”

Dental health status in children with type 1 diabetes mellitus in Montenegro

“…Diabetes mellitus (DM) is a metabolic disorder caused by an absolute or functional insulin deficiency. Type 1 diabetes mellitus (T1DM) is a common metabolic disease of childhood 1,2 . The main characteristic of childhood diabetes is unstability, variability, sudden changes in blood glucose levels from day to day, and changes that occur during growth and development.…”

Periodontal health in children with diabetes mellitus type 1 in Montenegro

“…Diabetes mellitus (DM) is systemic metabolic disorder characterized by hyperglycemia (a persistent increase in blood glucose level) resulting from insulin secretion disorder, disturbance of its function or both [1,2]. It is one of the most common endocrine disorders, with prevalence in the constant rise especially in developed countries.…”

“…This is due to the modern lifestyle and increase in the number of external etiological factors, among which obesity is particularly noticeable. DM is most common in older age as a result of general degenerative and sclerotic changes in the body (which also involve pancreas) while in children it may be due to genetic disorders or pancreas damage in certain infectious diseases [1,2].…”

“…Every ten seconds in the world one person dies of diabetes, and two new ones get sick. Children in 98% of cases experience unstable, ketosis-related, insulin-dependent diabetes mellitus (type 1), which is most commonly diagnosed in puberty [2,3]. Like all systemic diseases, DM gives many complications.…”