Dataset Information

Covariation of the incidence of type 1 diabetes with country characteristics available in public databases.

ABSTRACT: The incidence of Type 1 Diabetes (T1D) in children varies dramatically between countries. Part of the explanation must be sought in environmental factors. Increasingly, public databases provide information on country-to-country environmental differences.Information on the incidence of T1D and country characteristics were searched for in the 194 World Health Organization (WHO) member countries. T1D incidence was extracted from a systematic literature review of all papers published between 1975 and 2014, including the 2013 update from the International Diabetes Federation. The information on country characteristics was searched in public databases. We considered all indicators with a plausible relation with T1D and those previously reported as correlated with T1D, and for which there was less than 5% missing values. This yielded 77 indicators. Four domains were explored: Climate and environment, Demography, Economy, and Health Conditions. Bonferroni correction to correct false discovery rate (FDR) was used in bivariate analyses. Stepwise multiple regressions, served to identify independent predictors of the geographical variation of T1D.T1D incidence was estimated for 80 WHO countries. Forty-one significant correlations between T1D and the selected indicators were found. Stepwise Multiple Linear Regressions performed in the four explored domains indicated that the percentages of variance explained by the indicators were respectively 35% for Climate and environment, 33% for Demography, 45% for Economy, and 46% for Health conditions, and 51% in the Final model, where all variables selected by domain were considered. Significant environmental predictors of the country-to-country variation of T1D incidence included UV radiation, number of mobile cellular subscriptions in the country, health expenditure per capita, hepatitis B immunization and mean body mass index (BMI).The increasing availability of public databases providing information in all global environmental domains should allow new analyses to identify further geographical, behavioral, social and economic factors, or indicators that point to latent causal factors of T1D.

SUBMITTER: Diaz-Valencia PA

PROVIDER: S-EPMC4338253 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Covariation of the incidence of type 1 diabetes with country characteristics available in public databases.

Diaz-Valencia Paula Andrea PA Bougnères Pierre P Valleron Alain-Jacques AJ

PloS one 20150223 2

<h4>Background</h4>The incidence of Type 1 Diabetes (T1D) in children varies dramatically between countries. Part of the explanation must be sought in environmental factors. Increasingly, public databases provide information on country-to-country environmental differences.<h4>Methods</h4>Information on the incidence of T1D and country characteristics were searched for in the 194 World Health Organization (WHO) member countries. T1D incidence was extracted from a systematic literature review of a ...[more]

PMID: 25706995

Similar Datasets

Project description:Background:Clinical inertia is related to the difficulty of achieving and maintaining optimal glycemic control. It has been extensively studied the delay of the period to insulin introduction in type 2 diabetes mellitus (T2DM) patients. This study aims to evaluate clinical inertia of insulin treatment intensification in a group of T2DM patients followed at a tertiary public Diabetes Center with limited pharmacologic armamentarium (Metformin, Sulphonylurea and Human Insulin). Methods:This is a real life retrospective record based study with T2DM patients. Demographic, clinical and laboratory characteristics were reviewed. Clinical inertia was considered when the patients did not achieve the individualized glycemic goals and there were no changes on insulin daily dose in the period. Results:We studied 323 T2DM patients on insulin therapy (plus Metformin and or Sulphonylurea) for a period of 2 years. The insulin daily dose did not change in the period and the glycated hemoglobin (A1c) ranged from 8.8?+?1.8% to 8.7?±?1.7% (basal vs 1st year; ns) and to 8.5?±?1.8% (basal vs 2nd year; p?=?0.035). The clinical inertia prevalence was 65.8% (basal), 61.9% (after 1 year) and 58.2% (after 2 years; basal vs 1st year vs 2nd year; ns). In a subgroup of 100 patients, we also studied the first 2 years after insulin introduction. The insulin daily dose ranged from 0.22?±?0.12 to 0.32?±?0.24 IU/kg of body weight/day (basal vs 1st year; p?<?0.001) and to 0.39?±?0.26 IU/kg of body weight/day (basal vs 2nd year; p?<?0.05). The A1c ranged from 9.6?+?2.1% to 8.6?+?2% (basal vs 1st year; p?<?0.001) and to 8.7?+?1.7% (1st year vs 2nd year; ns). The clinical inertia prevalence was 78.5% (at the moment of insulin therapy introduction), 56.2% (after 1 year; p?=?0.001) and 62.2% (after 2 years; ns). Conclusion:Clinical inertia prevalence ranged from 56.2 to 78.5% at different moments of the insulin therapy (first 2 years and long term) of T2DM patients followed at a tertiary public Diabetes Center from an upper-middle income country with limited pharmacologic armamentarium.

Project description:BACKGROUND:To evaluate the characteristics of type 2 diabetes (T2DM) patients with or without chronic kidney disease (CKD) in Germany. METHODS:Using combined DPV/DIVE registry data, the analysis included patients with T2DM at least ??18 years old who had an estimated glomerular filtration rate (eGFR) value available. CKD was defined as an eGFR?<?60 mL/min/1.73 m2 or eGFR???60 mL/min/1.73 m2 and albuminuria (??30 mg/g). Median values of the most recent treatment year per patient are reported. RESULTS:Among 343,675 patients with T2DM 171,930 had CKD. Patients with CKD had a median eGFR of 48.9 mL/min/1.73 m2 and 51.2% had a urinary albumin level???30 mg/g. They were older, had a longer diabetes duration and a higher proportion was females compared to patients without CKD (all p?<?0.001). More than half of CKD patients (53.5%) were receiving long-acting insulin-based therapy versus around 39.1% of those without (p?<?0.001). CKD patients also had a higher rate of hypertension (79.4% vs 72.0%; p?<?0.001). The most common antihypertensive drugs among CKD patients were renin-angiotensin-aldosteron system inhibitors (angiotensin converting enzyme inhibitors 33.8%, angiotensin receptor blockers 14.2%) and diuretics (40.2%). CKD patients had a higher rate of dyslipidemia (88.4% vs 86.3%) with higher triglyceride levels (157.9 vs 151.0 mg/dL) and lower HDL-C levels (men: 40.0 vs 42.0 mg/dL; women: 46.4 vs 50.0 mg/dL) (all p?<?0.001) and a higher rate of hyperkalemia (>?5.5 mmol/L: 3.7% vs. 1.0%). Comorbidities were more common among CKD patients (p?<?0.001). CONCLUSION:The results illustrate the prevalence and morbidity burden associated with diabetic kidney disease in patients with T2DM in Germany. The data call for more attention to the presence of chronic kidney disease in patients with diabetes, should trigger intensified risk factor control up and beyond the control of blood glucose and HbA1c in these patients. They may also serve as a trigger for future investigations into this patient population asking for new treatment options to be developed.

Dataset Information

Covariation of the incidence of type 1 diabetes with country characteristics available in public databases.

Publications

Covariation of the incidence of type 1 diabetes with country characteristics available in public databases.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets