India saw the highest number of childhood diabetes cases and deaths in 2019 in the world, according to a new study published in the journal JAMA Network. The country also has the highest disability-adjusted life-years (DALY).
One DALY represents the loss of the equivalent of one year of full health, according to the World Health Organization.
Globally, in 2019, there were 227,580 cases of childhood diabetes, 5,390 deaths and 519,117 DALYs. This represents a 39.4 per cent increase in incident cases since 1990, the study noted.
“There is an urgent need for health care professionals to develop more cost-effective and targeted strategies that can mitigate childhood diabetes-associated morbidity and mortality, reduce the socioeconomic burden, and avoid the corresponding risks,” the researchers wrote in the study.
For many years, childhood diabetes generally constituted type 1 diabetes. An increasing prevalence of type 2 diabetes in children is being recorded due to the global epidemic of childhood obesity. Obesity and poor lifestyle, including sedentary living, could have contributed to the rise.
Most affected children also have a parental history of type 2 diabetes, the paper stated. Type 1 diabetes is an autoimmune reaction where the body attacks the cells in the pancreas that make insulin, which is needed to control normal blood glucose levels.
Experts analysed trends in diabetes incidence, diabetes-associated mortality and DALYs in children to 2019 from 1990 using data from the Global Burden of Diseases (GBD), 2019 in 204 countries and territories. They included risk factors for mortality as well.
The analysis included 1,449,897 children, consisting of 738,923 males and 710,974 females.
To explore the link between childhood diabetes burden and socioeconomic development, the researchers classified countries based on their score on their socioeconomic index (SDI), which ranges to 1 from 0. They were grouped into low, low-medium, medium, medium-high, and high
The largest increase in cases (52.06 per cent) was recorded in children aged 10 to 14 years and the smallest increase (30.52 per cent) in those aged between 1 and 4 years.
The incident rate in India was 10.92 and 11.68 in 1990 and 2019, respectively. Incidence rate describes how quickly a disease occurs in a population, according to the United States’ Centers for Disease Control and Prevention.
In contrast, the global number of diabetes-associated deaths in children dropped by 20 per cent to 5,390 in 2019 from 6,719 in 1990. Similarly, the diabetes-associated death rate decreased to 0.28 per 100,000 in 2019 from 0.38 per 100,000 in 1990.
Further, with 55,496 cases, the low-middle SDI region saw the highest increase in 2019 and the high-middle SDI region topped the list in diabetes incidence.
In 2019, the low SDI region showed the highest number of diabetes-associated deaths, with 2,367 fatal cases and the most diabetes-associated DALYs, with a dramatic increase of 59.92 per cent to 2019 from 1990.
Also, the low SDI region recorded the most diabetes-associated DALYs, an increase of 59.92 per cent to 2019 from 1990.
“Countries in the high SDI region like Monaco have a low diabetes disease burden and the lowest diabetes-associated mortality rate, whereas countries in the low SDI region like India have a high diabetes disease burden and high diabetes incidence,” the researchers wrote.
Further, South Asia had the highest burden of cases of childhood diabetes, childhood diabetes-associated deaths and childhood diabetes-associated DALYs in 2019.
Among the risk factors, environmental and occupational risks caused 6 per cent of childhood diabetes-associated deaths in 2019. This figure is similar in non-optimal temperatures as well. High and low temperatures caused 3 per cent of childhood diabetes-associated deaths in 2019.
Low and high temperatures pose greater risks among people with diabetes, according to a 2017 study.