ABSTRACT
AIM: To compare children with type 1 diabetes (T1D) living in the Northwest England, United Kingdom (UK) or Singapore, and to correlate age at diagnosis with birthweight and anthropometry at T1D diagnosis. METHODS: We included 166 T1D children of white ethnicity in England (UK-White) and 185 T1D children of East-Asian ethnicity origin in Singapore (SG-Asian) who were born between 2002 and 2020. RESULTS: The cohorts from UK-White and SG-Asian children differed significantly in FH of T1D (p < 0.001), FH of T2D (p < 0.001) and pubertal status at diagnosis (p = 0.01). Median interquartile range (IQR) for age at diagnosis was similar in the two groups. UK-White children had significantly higher birthweight SDS, height SDS, weight SDS and BMI SDS (all p < 0.001). Among the subgroup of 174 children who were prepubertal and diagnosed after age 5 years, the UK-White children were 11 months older than the SG-Asian children (p = 0.02) indicating that SG-Asian children at the time of T1D diagnosis were more likely to be in puberty compared with UK-White children (30% vs. 18%). CONCLUSION: These two cohorts have substantially different genetic and environmental backgrounds, yet age at the diagnosis of T1D was similar except for the prepubertal children who were diagnosed after 5 years old. Timing of puberty and other factors may influence how early T1D presents during childhood.
Subject(s)
Diabetes Mellitus, Type 1 , Anthropometry , Birth Weight , Child , Child, Preschool , Diabetes Mellitus, Type 1/diagnosis , England/epidemiology , Humans , Singapore/epidemiologyABSTRACT
AIM: To measure skin thickness (ST) and skinâ¯+â¯subcutaneous layer thickness (SCT) by ultrasound and estimate the risk of intramuscular injection (IM) with different needle lengths across injection sites according to age group. METHOD: Children recruited between 1 and 18â¯years with type 1 and 2 diabetes on insulin injections and divided into three age groups: 1-6â¯years, 7-12â¯years and 13-18â¯years. A portable ultrasound was used to measure ST and SCT at four injection sites on the abdomen, arm, thigh and buttock. RESULTS: Total 153 children enrolled for the study. The mean (SD) measurement of ST & SCT at four sites on abdomen, arm, thigh & buttocks were as follows; 4.33â¯mm (±2.22), 5.55â¯mm (±2.26), 5.83â¯mm (±3.12), 6.48â¯mm (±3.47) in 1-6â¯years old; 7.11â¯mm (±3.68), 7.79â¯mm (±4.54), 7.17â¯mm (±3.62), 8.51â¯mm (±3.65) in 7-12â¯years old; 8.94â¯mm (±4.50), 8.42â¯mm (±5.00), 8.61â¯mm (±4.76), 9.76â¯mm (±4.38) in 13-18â¯years old. Young children, 1-6â¯years have the highest risk of IM injection with all needle lengths, i.e. 4, 5, 6, 8 & 12.7â¯mm, while older children 7-12 & 13-18â¯years have a lower risk with shorter needles (4, 5 and 6â¯mm) as compared to longer needles (8 and 12.7â¯mm). CONCLUSIONS: Children with diabetes on insulin therapy should be advised on the appropriate needle length accordingly to their age and BMI.