Population-based incidence of diabetes in Australian youth aged 10-18 yr: increase in type 1 diabetes but not type 2 diabetes.

BACKGROUND: Global incidence of childhood type 2 diabetes has increased, with a greater rise amongst certain ethnic groups. OBJECTIVES: To examine the change in the incidence of type 1 and type 2 diabetes in Australian youth, aged 10-18 yr, in New South Wales, Australia. METHODS: Prospective population-based incidence study (2001-2008). Primary case ascertainment was from the Australasian Paediatric Endocrine Group Diabetes Register, secondary independent ascertainment from the National Diabetes Register. RESULTS: There were 202 incident cases of type 2 diabetes (96 boys, 48%). The mean age at diagnosis (±SD) was 14.6 ± 2.5 yr; 93% were overweight (International Obesity Taskforce Grade ≥1). Mean HbA1c was 8.8 ± 2.8%. Ethnicity was Caucasian 31%, Indigenous Australian 20%, Southeast Asian 11%, North African/Middle Eastern 9%, and NewZealander/Melanesian/Polynesian 8%. The mean annual incidence of type 2 diabetes was 3.0 per 100 000 per year (95% confidence interval (CI): 2.6-3.4) and did not change over time. The mean annual incidence of type 1 diabetes was 22.0 per 100 000 per year (95% CI: 20.8-23.1), and increased by 3.8% per year [incidence rate ratio IRR: 1.04, 95% CI: 1.02-1.06, p = 0.001]. Incidence was higher in Indigenous vs. non-Indigenous youth, IRR: 6.9 (95% CI: 4.7-10.2, p < 0.001). CONCLUSION: In 10-18 yr old youth, in Australia, the incidence of type 2 diabetes has remained steady during the last decade; however, the incidence of type 1 diabetes continues to rise. Most common diabetes in Australian youth is type 1 diabetes.

Predicting and Understanding the Pathology of Single Nucleotide Variants in Human COQ Genes.

Coenzyme Q (CoQ) is a vital lipid that functions as an electron carrier in the mitochondrial electron transport chain and as a membrane-soluble antioxidant. Deficiencies in CoQ lead to metabolic diseases with a wide range of clinical manifestations. There are currently few treatments that can slow or stop disease progression. Primary CoQ10 deficiency can arise from mutations in any of the COQ genes responsible for CoQ biosynthesis. While many mutations in these genes have been identified, the clinical significance of most of them remains unclear. Here we analyzed the structural and functional impact of 429 human missense single nucleotide variants (SNVs) that give rise to amino acid substitutions in the conserved and functional regions of human genes encoding a high molecular weight complex known as the CoQ synthome (or Complex Q), consisting of the COQ3-COQ7 and COQ9 gene products. Using structures of COQ polypeptides, close homologs, and AlphaFold models, we identified 115 SNVs that are potentially pathogenic. Further biochemical characterizations in model organisms such as Saccharomyces cerevisiae are required to validate the pathogenicity of the identified SNVs. Collectively, our results will provide a resource for clinicians during patient diagnosis and guide therapeutic efforts toward combating primary CoQ10 deficiency.

Birthplace is not a determinant of colorectal adenomas.

AIM: To examine the impact of the patient's birthplace on the prevalence of colonic polyps and histopathological subtypes. METHODS: This is a retrospective audit of the colonoscopy practice of one Gastroenterologist in a tertiary-referral hospital from 2008 to 2011. Data collected include demography, birthplace, language spoken, details of the colonoscopy including indications, completion rates, complications, results including prevalence and histopathology of polyps. Statistical methods used were binary logistic regression, χ(2) and Mann-Whitney U. RESULTS: A total of 623 patients (48% male, 67% aged over 50 years) were recruited and categorised according to birthplace: Australia/New Zealand 42%, European 20%, Asian 15%, Middle Eastern/African 11%, South American 9% and Pacific Islander 3%. The median age of the cohort was 56.3 years (range: 17-91 years), median body mass index 27.3 kg/m(2) (range: 16-51 kg/m(2)), 25% were smokers, 25% had hypercholesterolemia, 20% had diabetes mellitus 16% were on aspirin and 7% were on non-steroidal anti-inflammatory drugs. A total of 651 colonoscopies were performed for standard indications. The prevalence of polyps varied according to patient's birthplace: Europe 45.1%, Australia and New Zealand 39.5%, Pacific Islands 33.3%, Asia 30.3%, Middle East and Africa 26.9% and South America 24.5% (P = 0.027, df = 6). However, multivariate analysis revealed that birthplace was not an independent predictor of developing polyps, including adenomas and advanced adenomas after correcting for age and male sex. CONCLUSION: Birthplace is not a predictor for developing colorectal neoplasia, including adenomas and advanced adenomas; hence, should not influence the recommendations for colorectal cancer screening.

Glycaemic control in children with neonatal diabetes and type 1 diabetes in Vietnam.

Childhood diabetes care may be suboptimal in resource-poor countries. A cross-sectional study of youths with diabetes aged ≤19 years attending the three major paediatric centres in Vietnam was performed. Diabetes management was documented by questionnaire. Glycated haemoglobin (HbA1c) was measured with a fingerprick blood sample. Multiple linear regression analysis was used to examine factors associated with glycaemic control. In total, 105 patients participated, comprising 93 with type 1 diabetes and 12 with neonatal diabetes. The median age was 11.5 years [interquartile range (IQR) 6.4-14.5 years] and the median duration of diabetes was 2.6 years (IQR 1.5-6.1 years). Patients with type 1 diabetes performed few blood glucose tests per month (median 8, IQR 4-30). Mean HbA1c was higher in patients with type 1 diabetes compared with neonatal diabetes (9.9% vs. 7.5%; P = 0.01). In type 1 diabetes using multivariate analysis, higher HbA1c was associated with older age (ß = 0.3, 95% CI 0.2-0.4; P < 0.001), lower frequency of blood glucose monitoring (ß = -0.06, 95% CI -0.10 to 0.12; P = 0.01) and use of pre-mixed insulin (ß = -1.7, 95% CI -3.4 to 0.0; P = 0.05). In conclusion, international glycaemic control targets for childhood diabetes (HbA1c <7.5%) are not being achieved in Vietnam, and intensive diabetes management is rare. There is an urgent need to address barriers to achieving optimal control in this population.