Epidemiology of childhood-onset type 1 diabetes in Gran Canaria (2006-2018) / Epidemiología de la diabetes tipo 1 en la infancia en Gran Canaria (2006-2018)

AIMS: To study the incidence of type 1 diabetes (T1D) in children <14 years in the island of Gran Canaria (Canary Islands, Spain) during the 2006-2018 period and to evaluate its temporal trend, seasonality, age and sex distribution. Subjects and methods: We studied children <14 years of age living in Gran Canaria. We calculated the annual and overall incidence using recorded data from the Pediatric Endocrinology Department as the primary source and the local Diabetes Association and the hospital's pharmacy as secondary sources. The primary source is the only paediatric endocrine unit in the island. RESULTS: 453 new T1D cases were observed during the 13-year period. The overall incidence of T1D between 2006 and 2018 was 30.48/100,000 (95% CI: 27.74-33.42). Distribution among age groups was 24.8%, 38.2% and 36.9% for children between 0-4, 5-9 and 10-13.9 years old respectively. No significant temporal trend, seasonality or sex differences were found. CONCLUSIONS: Our study shows that the Island of Gran Canaria has one of the highest childhood incidences of T1D reported worldwide: among the highest rates in Europe, and higher than the rates published for the neighbouring African countries

OBJETIVOS: Estudiar la incidencia de diabetes mellitus tipo 1 (DM1) en niños menores de 14 años en la isla de Gran Canaria (Islas Canarias, España) durante el período 2006-2018, así como evaluar su tendencia temporal, estacionalidad y distribución por sexo y edad. Sujetos y métodos: Los sujetos objeto de estudio fueron los niños menores de 14 años que habitan la isla de Gran Canaria. Calculamos la incidencia para todo el período, y la incidencia anual usando los datos recogidos en nuestra unidad de endocrinología pediátrica como fuente primaria y los datos de la asociación local de diabetes y la farmacia hospitalaria como fuentes secundarias. La fuente primaria es la única unidad de endocrinología pediátrica de la isla. RESULTADOS: Observamos un total de 453 nuevos casos de DM1 durante el período de estudio. La incidencia global para el período 2006-2018 fue de 30,48/100.000 (IC 95%: 27,74-33,42). La distribución por grupos de edad fue del 24,8, 38,2 y 36,9% para niños entre 0-4, 5-9 y 10-13,9 años de edad, respectivamente. No encontramos la aparición de ninguna tendencia temporal significativa. Tampoco encontramos la presencia de estacionalidad ni diferencias significativas en cuanto a la aparición de DM1 en base al sexo. CONCLUSIONES: Nuestro estudio muestra que la isla de Gran Canaria presenta una de las incidencias de DM1 más altas del mundo. Se encuentra entre las más altas de Europa, y es claramente superior a la publicada para los países vecinos africanos

Epidemiology of childhood-onset type 1 diabetes in Gran Canaria (2006-2018).

AIMS: To study the incidence of type 1 diabetes (T1D) in children <14 years in the island of Gran Canaria (Canary Islands, Spain) during the 2006-2018 period and to evaluate its temporal trend, seasonality, age and sex distribution. SUBJECTS AND METHODS: We studied children <14 years of age living in Gran Canaria. We calculated the annual and overall incidence using recorded data from the Pediatric Endocrinology Department as the primary source and the local Diabetes Association and the hospital's pharmacy as secondary sources. The primary source is the only paediatric endocrine unit in the island. RESULTS: 453 new T1D cases were observed during the 13-year period. The overall incidence of T1D between 2006 and 2018 was 30.48/100,000 (95% CI: 27.74-33.42). Distribution among age groups was 24.8%, 38.2% and 36.9% for children between 0-4, 5-9 and 10-13.9 years old respectively. No significant temporal trend, seasonality or sex differences were found. CONCLUSIONS: Our study shows that the Island of Gran Canaria has one of the highest childhood incidences of T1D reported worldwide: among the highest rates in Europe, and higher than the rates published for the neighbouring African countries.

Combined treatment with GH and anastrozole in a pubertal boy with Cushing's disease and postsurgical GH deficiency.

Growth failure is a characteristic manifestation of pediatric Cushing's disease. Catch-up growth is usually incomplete after cure of the disease, and final height is often compromised. Possible mechanisms for this phenomenon include postoperative persistence of GH hyposecretion and absence of retardation of bone maturation in spite of GH deficiency. This report describes the outcome in the case of a boy with Cushing's disease for whom GH replacement therapy was combined with anastrozole, an aromatase inhibitor, in order to delay skeletal maturation and extend the available time for linear growth. The case of a 14 years 4-months-old pubertal male (Tanner stage III) with GH deficiency after successful surgical treatment of Cushing's disease is presented. His height was 147.2 cm (-2.34 SDS), and his midparental target height 171.2 cm (-0.95 SDS). Bone age was 13.5 years and predicted adult height 163.2 cm (-2.2 SDS). Combined treatment was administered for 2.5 years. GH was maintained up to age 18 years. Anastrozole induced a substantial deceleration of bone age. Near-final height at 18 years was 169.5 cm (-1.07 SDS). Puberty progressed normally. Compared with population reference data, bone mineral density before GH plus anastrozole treatment was -4.07 SDS in the lumbar spine and -1.85 SDS in the femoral neck. These measures increased to -1.95 and -0.89 SDSs respectively, at 18 years, when GH was discontinued. Combined treatment with GH and aromatase inhibitors could be a therapeutic alternative to improve the stature of pubertal boys with Cushing's disease and postsurgical GH deficiency.

Perinatal endocrinology: common endocrine disorders in the sick and premature newborn.

Endocrine disorders are common in infants in the neonatal ICU. They often are associated with prematurity, low birth weight or very low birth weight, and small size for gestational age. They also frequently occur in infants who are critically ill or stressed. This article describes the most common conditions and current knowledge regarding management.

Recent consensus statements in pediatric endocrinology: a selective review.

Clinical guidelines and consensus statements serve to summarize and organize current knowledge on diverse subjects and provide practical guidelines for proper clinical management. Recommendations should be based on research and evidence derived from appropriate sources. In 2008, more than 20 consensus statements were published in the pediatric literature alone. This article summarizes the salient points of the latest consensus statements jointly developed by multiple endocrine societies including the Lawson Wilkins Society for Pediatric Endocrinology and the European Society for Pediatric Endocrinology. As much as possible, the original intent and language of the statements was respected and paraphrased.

Recent consensus statements in pediatric endocrinology: a selective review.

Clinical guidelines and consensus statements serve to summarize and organize current knowledge on diverse subjects, and provide practical guidelines for proper clinical management. Recommendations should be based on research and evidence derived from appropriate sources. In 2008, more than 20 consensus statements were published in the pediatric literature alone. This article summarizes the salient points of the latest consensus statements jointly developed by multiple endocrine societies including the Lawson Wilkins Society for Pediatric Endocrinology and the European Society for Pediatric Endocrinology. As much as possible, the original intent and language of the statements was respected and paraphrased.

Perinatal endocrinology: common endocrine disorders in the sick and premature newborn.

Endocrine disorders are common in infants in the neonatal ICU. They often are associated with prematurity, low birth weight or very low birth weight, and small size for gestational age. They also frequently occur in infants who are critically ill or stressed. This article describes the most common conditions and current knowledge regarding management.