Incidence of type 1 diabetes in China, 2010-13: population based study.
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ABSTRACT:
SUBMITTER: Weng J
PROVIDER: S-EPMC5750780 | biostudies-literature | 2018 Jan
REPOSITORIES: biostudies-literature
Publications
Incidence of type 1 diabetes in China, 2010-13: population based study.
Weng Jianping J Zhou Zhiguang Z Guo Lixin L Zhu Dalong D Ji Linong L Luo Xiaoping X Mu Yiming Y Jia Weiping W
BMJ (Clinical research ed.) 20180103
<h4>Objective</h4>To estimate the incidence of type 1 diabetes in all age groups in China during 2010-13.<h4>Design</h4>Population based, registry study using data from multiple independent sources.<h4>Setting</h4>National registration system in all 505 hospitals providing diabetes care, and communities of patients with diabetes in 13 areas across China, covering more than 133 million person years at risk, approximately 10% of the whole population.<h4>Participants</h4>5018 people of all ages wit ...[more]
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| S-EPMC8736690 | biostudies-literature
Project description:OBJECTIVE:To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:?13 years). DESIGN:A population-based retrospective longitudinal cohort study. SETTING:Taiwan's National Health Insurance medical claims. PARTICIPANTS:4007 patients newly diagnosed with type 1 diabetes were identified during 1999-2012. OUTCOME MEASURES:Acute complications included diabetic ketoacidosis (DKA) and hypoglycaemia. Chronic complications were cardiovascular diseases (CVD), retinopathy, neuropathy and nephropathy. RESULTS:The incidence density of retinopathy was greatest (97.74 per 1000 person-years), followed by those of nephropathy (31.36), neuropathy (23.93) and CVD (4.39). Among acute complications, the incidence density of DKA was greatest (121.11 per 1000 person-years). The cumulative incidences of acute complications after 12 years following diagnosis were estimated to be 52.1%, 36.1% and 4.1% for DKA, outpatient hypoglycaemia and hospitalised hypoglycaemia, respectively. For chronic complications, the cumulative incidence of retinopathy after 12 years following diagnosis was greatest (65.2%), followed by those of nephropathy (30.2%), neuropathy (23.7%) and CVD (4.1%). Females with late-onset diabetes were greatly affected by advanced retinopathy (ie, sight-threatening diabetic retinopathy) and hospitalised hypoglycaemia, whereas those with early-onset diabetes were more vulnerable to DKA. Chronic complications were more commonly seen in late-onset diabetes, whereas early-onset diabetes were most affected by acute complications. CONCLUSIONS:Ethnic Chinese patients with type 1 diabetes were greatly affected by DKA and retinopathy. The incidence of diabetes-related complications differed by age at diagnosis and sex.
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Project description:BACKGROUND:A re-emergence of scarlet fever has been noted in Hong Kong, South Korea, and England, UK, since 2008. China also had a sudden increase in the incidence of the disease in 2011. In this study, we aimed to assess the epidemiological changes before and after the upsurge. We also aimed to explore the reasons for the upsurge in disease in 2011, the epidemiological factors that contributed to it, and assess how these could be managed to prevent future epidemics. METHODS:In this observational study, we extracted the epidemiological data for all cases of scarlet fever between 2004 and 2016 in China from the Chinese Public Health Science Data Center, the official website of National Health Commission of the People's Republic of China, and the National Notifiable Infectious Disease Surveillance System. These data had been collected from 31 provinces and regions in China and included geographical, seasonal, and patient demographic information. We used descriptive statistical methods and joinpoint regression to examine the spatiotemporal patterns and annual percentage change in incidence of the upsurge of disease across China. FINDINGS:Between Jan 1, 2004, and Dec 31, 2016, 502?723 cases of scarlet fever, with ten fatalities, were reported in China, resulting in an annualised average incidence of 2·8807 per 100?000 people. The annual average incidence increased from 1·457 per 100?000 people in 2004 to 4·7638 per 100?000 people in 2011 (incidence rate ratio [IRR] 3·27, 95% CI 3·22-3·32; p<0·0001), peaking in 2015 (5·0092 per 100?000 people). The annual incidence after the 2011 upsurge of scarlet fever, between 2011 and 2016, was twice the average annual incidence reported between 2004 and 2010 (4·0125 vs 1·9105 per 100?000 people; IRR 2·07, 95% CI 2·06-2·09; p<0·0001). Most cases were distributed in the north, northeast, and northwest of the country. Semi-annual patterns were observed in May-June and November-December. The median age at onset of disease was 6 years, with the annual highest incidence observed in children aged 6 years (49·4675 per 100?000 people). The incidence among boys and men was 1·54 greater than that among girls and women before the upsurge, and 1·51 times greater after the upsurge (p<0·0001 for both). The median time from disease onset to reporting of the disease was shorter after the upsurge in disease than before (3 days vs 4 days; p=0·001). INTERPRETATION:To our knowledge, this is the largest epidemiological study of scarlet fever worldwide. The patterns of infection across the country were similar before and after the 2011 upsurge, but the incidence of disease was substantially higher after 2011. Prevention and control strategies being implemented in response to this threat include improving disease surveillance and emergency response systems. In particular, the school absenteeism and symptom monitoring and early-warning system will contribute to the early diagnosis and report of the scarlet fever. This approach will help combat scarlet fever and other childhood infectious diseases in China. FUNDING:National Key R&D Plan of China Science and key epidemiological disciplines of Zhejiang Provincial Health of China.
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