Diabetes is a global health problem. It is characterized by the body producing little or no insulin, or an ineffective response to this hormone, resulting in abnormally high blood sugar levels.
Among the different types of diabetes, type 1 is the most common in children and adolescents. In 2019, approximately 1.5 million young people under the age of 20 suffered from this disease worldwide. Furthermore, of the 16,300 deaths due to diabetes in those under the age of 25, 73.7% were due to type 1 diabetes.
Despite progress, management of this disease remains a global challenge for health systems.
A major health problem in children
Type 1 diabetes is a chronic autoimmune disease in which the immune system (defense system against pathogens) attacks and destroys the cells in the pancreas responsible for producing insulin. To compensate for this deficiency, patients must obtain this hormone through injections or administration devices (insulin pumps).
Additionally, people with diabetes must monitor their blood sugar levels, as well as manage their nutritional intake (especially carbohydrates), physical activity, and other aspects that can alter this glucose level.
Poor disease management causes blood sugar levels to rise. And this situation, maintained over time, can affect and damage the main organs of the body: heart, blood vessels, nerves, eyes or kidneys.
It is therefore important to know the evolution of the number of young people affected by the pathology, to try to identify the causes and to be able to provide the health authorities with epidemiological data to identify new cases as early as possible.
Almost double the incidence
To this end, a group of researchers examined the incidence – that is, the proportion of new cases of a disease over a given period compared to the population likely to suffer from it – of type 1 diabetes in 32 European countries from 1994 to 2021. To do this, we analyzed a total of 75 studies, covering 219,331 individuals aged 0 to 14 years.
We were able to observe that this incidence has increased considerably: from 11 cases per 100,000 people/year from 1994 to 2003 to 21 cases per 100,000 people/year between 2013 and 2021 approximately.
Differences between countries
Furthermore, we detected significant differences between regions. While the trend has clearly increased in most European countries – particularly those in northern Europe (Finland, Sweden or Norway) – a certain stabilisation has been observed in countries such as the United Kingdom and Spain.
Between 2013 and 2021, the last period studied, the lowest incidence rates were recorded in Romania and Turkey (respectively 11 and 12 cases per 100,000 people/year), and the highest in Finland and Ireland (56 and 33 cases).
In Spain, as we have previously highlighted, there is some stability. Between 1994 and 2003, 16 cases were recorded per 100,000 inhabitants/year, with a slight increase to 17.5 between 2013 and 2022.
Both in this country and in the rest of Europe, boys have slightly higher figures than girls. We also observed that incidence rates increased with age, particularly in the 10-14 age group.
What could be behind this upward trend?
The origin of type 1 diabetes is still unknown, although some research indicates that there is a genetic predisposition. Other triggers are also considered: autoimmune processes, viruses, lifestyle and environmental factors, including diet.
For example, we observed that higher income per capita or living in a more northern country, such as Finland, Sweden or Norway, could influence the incidence of type 1 diabetes.
There are several possible explanations for this. Ultraviolet radiation is different depending on geographic latitude, and several studies have found a protective factor in exposure to this radiation, as it appears to slow down the body’s immune responses.
The pandemic factor
Another interesting fact is that there has been an increase in new cases of type 1 diabetes among minors worldwide since the covid-19 pandemic.
This could be due to the effect of the infection on the immunity of subjects vulnerable to this disease, or to a possible decrease in the capacity of health systems to detect the problem early and control it.
Currently, work needs to continue on health policies aimed at promoting healthy lifestyles and controlling risk factors, such as environmental factors, which could be at the origin of the immune problems linked to this important public health problem.
About the authors: Marta Carolina Ruiz Grao and Miriam Garrido Miguel are professors at the Faculty of Nursing of Albacete (UCLM). Ana Díez-Fernández is professor at the Faculty of Nursing of Cuenca.
This article was originally published on The Conversation. Read the original.
