Prevalence of monogenic diabetes amongst Polish children after a nationwide genetic screening campaign.
OBJECTIVE
The aim of this study was to study dynamic changes in the prevalence of different types of diabetes in paediatric populations in Poland, with a specific focus on monogenic diabetes (MD).


METHODS
Using epidemiologic data (PolPeDiab Collaboration) and nationwide genetic test results (TEAM Programme), we compared the prevalence of type 1, type 2 and cystic fibrosis-related diabetes (CFRD) and MD. Genetically confirmed MD included MODY, neonatal diabetes and Wolfram and Alström syndromes. The study covered all children aged 0-18 years treated for diabetes between 2005 and 2011 in three regions, inhabited by 23.7% (1,989,988) of Polish children, with a low prevalence of childhood obesity (<5%).


RESULTS
The prevalence of type 1 diabetes showed a continuous increase, from 96 to 138/100,000 children. The prevalence of type 2 diabetes and CFRD also increased, from 0.3 to 1.01/100,000 children and from 0.1 to 0.95/100,000 children, respectively. The prevalence of MD was stable at between 4.2 and 4.6/100,000 children, accounting for 3.1-4.2% of children with diabetes, with glucokinase (GCK)-MODY being the most frequent type, amounting to 83% of patients with MD. The percentage of positive test results decreased with the number of referrals, suggesting that children with the highest probability of MD were referred initially, followed by those with a less clear-cut phenotype. The prevalence of neonatal diabetes equalled 1 in 300,000 children.


CONCLUSIONS
The prevalence of MD in a paediatric population with a low prevalence of obesity remains stable and is nearly fivefold higher than that of type 2 diabetes and CFRD, justifying a need for increased access to genetic diagnostic procedures in diabetic children.
Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, 36/50 Sporna Str., 91-738, Lodz, Poland.
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Fendler
Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, 36/50 Sporna Str., 91-738, Lodz, Poland.
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Borowiec
Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, 36/50 Sporna Str., 91-738, Lodz, Poland.
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Baranowska-Jazwiecka
Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, 36/50 Sporna Str., 91-738, Lodz, Poland.
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Szadkowska
Department of Paediatrics, Endocrinology and Diabetes, Silesian Medical University of Katowice, Katowice, Poland.
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Skala-Zamorowska
Department of Paediatrics, Endocrinology and Diabetes, Silesian Medical University of Katowice, Katowice, Poland.
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Deja
Department of Paediatrics, Endocrinology and Diabetes, Silesian Medical University of Katowice, Katowice, Poland.
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Jarosz-Chobot
Department of Paediatrics, Oncology, Haematology and Endocrinology, Medical University of Gdansk, Gdansk, Poland.
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Techmanska
Department of Paediatrics, Oncology, Haematology and Endocrinology, Medical University of Gdansk, Gdansk, Poland.
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Bautembach-Minkowska
Department of Paediatrics, Oncology, Haematology and Endocrinology, Medical University of Gdansk, Gdansk, Poland.
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Mysliwiec
Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, 36/50 Sporna Str., 91-738, Lodz, Poland.
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Zmyslowska
Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, 36/50 Sporna Str., 91-738, Lodz, Poland.
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Pietrzak
Department of Metabolic Diseases, Collegium Medicum Jagiellonian University of Cracow, Cracow, Poland.
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Malecki
Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, 36/50 Sporna Str., 91-738, Lodz, Poland. Wojciech.Mlynarski@umed.lodz.pl.
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Mlynarski
D000293:Adolescent; D056769:Alstrom Syndrome / Q000453:epidemiology / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications; D003920:Diabetes Mellitus / Q000145:classification / Q000453:epidemiology* / Q000235:genetics*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000235:genetics; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000235:genetics; D005820:Genetic Testing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009313:National Health Programs / Q000706:statistics & numerical data*; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D014929:Wolfram Syndrome / Q000453:epidemiology / Q000235:genetics