Time trend in excess mortality in children with type 1 diabetes from 1987 to 2016 in mainland France

Donzeau, Aurélie; Piffaretti, Clara; Jossens, Anne; Levaillant, Lucie; Bouhours‐Nouet, Natacha; Amsellem‐Jager, Jessica; Ghosn, Walid; Rey, Grégoire; Fosse-Edorh, Sandrine; Coutant, Régis

doi:10.1111/pedi.13298

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…Despite the developments in clinical care in recent years, the mortality risk for people developing type 1 diabetes in childhood remains high in young adult life before the onset of chronic complications. 24,25…”

Section: Rate Controlmentioning

confidence: 99%

Epidemiological profile and diabetes control of Type 1 Diabetes Mellitus patients in Karbala Governorate, Iraq

et al. 2023

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Background: Type1 Diabetes Mellitus is a common chronic diseases among children, and associated with morbidity, mortality, and enormous healthcare expenditures. Objectives; to estimate the prevalence, incidence, and describe the epidemiological characteristics of Type 1 Diabetes Mellitus among children in Karbala governorate, Methods: A cross-sectional study was conducted among all children who attended the main DM center in Karbala Teaching Hospital for Children, Public Clinics, and Primary Health Care centers. Data was collected by structured questionnaire and biochemical and anthropometric measurements. The statistical analysis data entry was conducted using Statistical Package for Social Sciences. Results: Total number of Type 1 Diabetes Mellitus patients aged 0-15 years in Karbala in 2015 was 199; making 44.66/1005. Fifty-four patients were newly diagnosed patients making an incidence of 12.11/1005. There was nearly equal distribution among both sexes. Most of the cases were from urban areas and most of the patients had a Family history of Type 2 Diabetes Mellitus. Diabetic ketoacidosis was reported in 16.8% of the patients. Only 31.6% of patients had HbA1c < 7%. Half of the patients had a history of admission to the hospital for diabetes. Logistic regression analysis revealed that the only independent variables significantly correlated with poor glycemic control were lack of Self-Monitoring Blood Glucose, irregular visits to the Diabetic Center, and positive family history of diabetes. Conclusion: Only one-third of T1DM children in Karbala city had controlled blood sugar. Lack of regular blood glucose monitoring and irregular contact with health care providers were the main determinants of uncontrolled blood sugar.

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Section: Rate Controlmentioning

confidence: 99%

Epidemiological profile and diabetes control of Type 1 Diabetes Mellitus patients in Karbala Governorate, Iraq

et al. 2023

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“…Recent data are important as treatment and management of type 1 diabetes is rapidly evolving. Mortality rates for people with type 1 diabetes have decreased over the last two decades by ∼2.1% per year in Australia and up to 5.8% per year in Denmark [2]; however, as Donzeau et al [3] identified, few studies of childhood-onset type 1 diabetes have included recent mortality data from 2010 onwards.…”

Section: Introductionmentioning

confidence: 99%

Excess Mortality in an Inception Cohort of Childhood Diabetes Diagnosed 1990–2010

Lain,

Stevens,

Craig

et al. 2024

Pediatric Diabetes

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Objective. Evaluate the mortality risk of childhood-onset type 1 diabetes compared to the general population. Research Design and Methods. The study population, identified from the Australasian Paediatric Endocrinology Group diabetes register, was diagnosed with type 1 diabetes at age < 16 in New South Wales (NSW), Australia, from 1990 to 2010. The register was linked to National Death Index registrations to ascertain timing and cause of death up to 31/12/2022. Risk factors for mortality were assessed using multivariable Cox regression models and observed mortality rate compared to “expected” rates in the Australian general population using indirect-standardized mortality ratios (SMR), overall and by sex and age at diagnosis. Diabetes-related cause of death categories were identified. Results. Of 5,417 children diagnosed with type 1 diabetes, 157 subsequently died, with all-cause mortality of 1.37/1,000 person years. Increased mortality risk was associated with living in most disadvantaged areas (aHR 1.81 (1.05, 3.11)) but not living in a rural area. Overall SMR was 2.83 (95% CI 2.40, 3.33) with females having higher SMR than males (4.18 vs. 2.19). Most common causes of death recorded were acute diabetes complications (26%), including diabetes ketoacidosis, accident/misadventure (21%), and chronic diabetes complications (15%). Alcohol and/or drug use contributed to 17% of deaths. Conclusion. Compared to the general population, higher risk of mortality in people with type 1 diabetes was associated with female sex and living in area of socioeconomic disadvantage. Education about minimizing risk-taking behaviors should be communicated to young adults with type 1 diabetes.

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“…Nevertheless, hypoglycemia remains the most common acute complication of T1D. It can give rise to a wide range of symptoms, from mild events with palpitations, sweatiness and shakiness to severe with neurological symptoms, seizures with coma and potentially death 14 15. Even mild hypoglycemic events, and also fear of hypoglycemia, are a hurdle for achieving optimal glycemic levels.…”

Section: Introductionmentioning

confidence: 99%

Real-life data of hypoglycemic events in children and adolescents with type 1 diabetes

Hill,

Klaar,

Espes

2023

BMJ Open Diab Res Care

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IntroductionHypoglycemia composes an always present risk in the treatment of type 1 diabetes (T1D) and can be a fatal complication. Many studies on hypoglycemic events are based on self-reported data or focused on the aggregated time below range. We have processed continuous glucose monitoring (CGM) data in children and adolescents with T1D in order to examine all occurring hypoglycemic events.Research design and methodsCGM data (mean 168±3 days) from 214 children and adolescents with T1D were analyzed using computer-based algorithms. Patients were divided into three groups based on estimated HbA1c (eHbA1c): (1) ≤48 mmol/mol (n=58); (2) 49–64 mmol/mol (n=113); (3) ≥65 mmol/mol (n=43). The groups were compared concerning descriptive data and CGM metrics with emphasis on the frequency of hypoglycemic events.ResultsOnly one self-reported event of severe hypoglycemia was registered, while 54 390 hypoglycemic events (<3.9 mmol/L (<70 mg/dL)) were identified from CGM data out of which 11 740 were serious (<3.0 mmol/L (<54 mg/dL)). On average there were 1.5±0.1 hypoglycemic events per 24 hours out of which 1.2±0.1 were mild (3.0–3.9 mmol/L) and 0.3±0.02 serious. Group 1 had a higher frequency of both total and mild hypoglycemic events compared with both groups 2 and 3. However, the frequency of serious hypoglycemic events was similar in all groups. A negative correlation was observed for eHbA1c and total daily and mild hypoglycemic events (r=−0.57 and r=−0.66, respectively, p<0.0001), whereas for serious hypoglycemic events there was only a borderline significance (r=−0.13, p=0.05).ConclusionsThis study shows that hypoglycemic events are a frequent phenomenon in children and adolescents with T1D, occurring regardless of overall metabolic control. Although patients with an HbA1c ≤48 mmol/mol had a higher frequency of mild hypoglycemic events there was no increase in serious hypoglycemic events.

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Time trend in excess mortality in children with type 1 diabetes from 1987 to 2016 in mainland France

Cited by 8 publications

References 30 publications

Epidemiological profile and diabetes control of Type 1 Diabetes Mellitus patients in Karbala Governorate, Iraq

Epidemiological profile and diabetes control of Type 1 Diabetes Mellitus patients in Karbala Governorate, Iraq

Excess Mortality in an Inception Cohort of Childhood Diabetes Diagnosed 1990–2010

Real-life data of hypoglycemic events in children and adolescents with type 1 diabetes

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