Does social-economical transformation influence the incidence of type 1 diabetes mellitus? A Polish example.
BACKGROUND
The dramatic increase in the incidence of diabetes mellitus type 1 (DMT1) in all countries of Central and Eastern Europe seems to be correlated with the rapid transformations of the political, economical, and social conditions. The aim of this study was to analyze the increase of DMT1 incidence vs. changes of parameters describing economical conditions, medical care standards, and level of hygiene.


METHODS
The study was based on the Upper Silesia, Poland, prospective register of DMT1 cases, a part of the EURODIAB program. The analyzed parameters were number of salmonellosis, taeniasis, diarrhea, and diarrhea in children aged 0 - 2 yr, alimentary toxicosis, neonatal mortality rate, average male and female life expectancy, gross domestic product (GDP), and accessibility to the water supply and sewage lines.


RESULTS
The dynamics of incidence increase has been very high: from 4.71/100 000 (1989) to 15.20/100 000 (2002); average increase per year is 7.52%. The statistically significant positive associations between DMT1 incidence and average male and female life expectancy, GDP, and accessibility of the water supply and sewage systems as well as the negative association for both neonatal mortality rate and nursery attendance were observed. No significant correlation was found between DMT1 and incidence rates of chosen diseases.


CONCLUSIONS
Currently, Poland and its part, Upper Silesia, belong to regions with high DMT1 incidence in children. The change from low to high incidence of DMT1 over the past 14 yr corresponded to profound social and economical transformations. Our observations confirm the importance of environmental factors in the aetiopathogenesis of DMT1. The state of hygiene and the state of the health of the society influence its susceptibility to DMT1.
Department of Pediatric Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland. piarosz-chobot@slam.katowice.pl
Przemyslawa
P
Jarosz-Chobot
Joanna
J
Polanska
Andrzej
A
Polanski
D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003967:Diarrhea / Q000453:epidemiology; D006296:Health Services / Q000592:standards; D006801:Humans; D006920:Hygiene; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D011044:Poland / Q000453:epidemiology; D012042:Registries; D012722:Sewage; D012959:Socioeconomic Factors
D012722:Sewage