title: Incidence of type 1 diabetes mellitus during 26 years of observation and prevalence of diabetic ketoacidosis in the later years.
abstract: The prevalence of type 1 diabetes (T1D) varies greatly between countries. However, over the past several decades, a global rise in the incidence of T1D in the pediatric population has been noted. The aim of our study was to investigate the incidence of T1D in children living in the Lesser Poland during the period of time from January 1, 1987, to December 31, 2012, and to analyze the demographic characteristics and occurrence of diabetic ketoacidosis (DKA) in patients with newly diagnosed T1D in the second part of the study (2006-2012). During 26 years, 636 children (331 boys, 305 girls) aged 0-14 years were newly diagnosed with T1D (0-4 years old, n = 131; 5-9 years old, n = 253, 10-14 years old, n = 252). The standardized incidence ratio (SIR) ranged significantly (p < 0.001) from 5.2/100,000/year in 1987 to 21.9/100,000/year in 2012. The highest SIR was observed in age group 5-9 years old (21.2) and the lowest in 0-4 years old (8.8). There was no association with sex or living in urban or rural area. On admission, DKA was diagnosed in 22.4 % of patients. There were no significant differences relating to the presence of DKA (p = 0.912) in subsequent years.
  
  
  CONCLUSIONS
  The incidence of T1D among children is increasing rapidly with the highest SIR in the 5-9 years old age group. DKA is still an important problem in the pediatric population.
  
  
  BACKGROUND
  • The incidence of pediatric type 1 diabetes mellitus in Europe is increasing. The initial manifestation of the type 1 diabetes mellitus is diabetic ketoacidosis. What is New: • This is the longest (26 years) continuous analysis of the incidence of type 1 diabetes in Poland and the first analysis focused on the incidence rate and also on presence of diabetic ketoacidosis.
authors.affiliation: Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland. wojcik.gosia@gmail.com.|Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland. wojcik.gosia@gmail.com.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Wojcik
authors.affiliation: Student's Scientific Group, Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland. curzytekm@gmail.com.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Sudacka
authors.affiliation: Student's Scientific Group, Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland. b.wasyl@gmail.com.
authors.forename: Barbara
authors.initials: B
authors.lastname: Wasyl
authors.affiliation: Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland. mm.ciechanowska@gmail.com.
authors.forename: Marta
authors.initials: M
authors.lastname: Ciechanowska
authors.affiliation: Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland. joanna.nazim@uj.edu.pl.|Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland. joanna.nazim@uj.edu.pl.
authors.forename: Joanna
authors.initials: J
authors.lastname: Nazim
authors.affiliation: Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland. stelmal@op.pl.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Stelmach
authors.affiliation: Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland. jerzy.stazryk@uj.edu.pl.|Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland. jerzy.stazryk@uj.edu.pl.
authors.forename: Jerzy B
authors.initials: JB
authors.lastname: Starzyk
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution
chemical_list: D001786:Blood Glucose
keywords: Diabetic ketoacidosis; Incidence; Type 1 diabetes mellitus