Clinical and epidemiological characteristics of diabetes mellitus in children of the Republic of Sakha (Yakutia)

BACKGROUND: The study of the clinical and epidemiological characteristics of any pathology in regions with a centralized medical care system is very informative. Thus, the Republic of Sakha (Yakutia) is very interesting for conducting epidemiological studies in view of the possibility of accounting for all cases of diabetes in children in the Department of Pediatric Endocrinology and Gastroenterology of the Pediatric Center of the Republic hospital № 1 — the National Center of Medicine named after M.E. Nikolaev (RH№1 — NCM named after M.E. Nikolaev), the population of the region is ethnically heterogeneous.

OBJECTIVE: To study the clinical and epidemiological characteristics of type 1 and type 2 diabetes mellitus in the Republic of Sakha (Yakutia).

MATERIALS AND METHODS: The article describe the clinical and epidemiological characteristics of type 1 and type 2 diabetes in children in the Republic of Sakha (Yakutia). According to official statistics, an increase in the incidence of diabetes mellitus in children has been revealed in the period from 2018–2024.

RESULTS: According to the data of the republican registry of the Department of Endocrinology and Gastroenterology of the Pediatric Center of the RH№1 — NCM named after M.E. Nikolaev, the age of the debut, the ethnic characteristics of the patient population, age-sex characteristics and features of therapy were determined. Over the past 7 years, the Republic of Sakha (Yakutia) has seen a steady increase in the incidence of type 1 and type 2 diabetes among children aged 0–17 years. Yakut and Russian children suffer from type 1 diabetes equally often, and Yakut children mostly suffer from type 2 diabetes. The age of onset of type 1 diabetes is 10–14 years, and girls are more likely to be ill. 90% of children at the onset of type 1 diabetes are admitted in a state of ketoacidosis. In the treatment of type 1 diabetes, a combination of insulin analogues is used, with type 2 diabetes mainly metformin.

CONCLUSION: The clinical and epidemiological situation of diabetes mellitus in children and adolescents in the Republic of Sakha (Yakutia) requires special attention and the adoption of new organizational measures within the framework of federal and regional programs.

1. Global Diabetes Report. Geneva: World Health Organization; 2018. (In Russ.)

2. Dedov II, Shestakova MV, Vikulova OK, et al. Dynamics of clinical and epidemiological indicators of diabetes mellitus in the Russian Federation in 2018-2022. In: Personalized medicine and practical healthcare. collection of abstracts of the X (XXIX) National Congress of Endocrinologists with international participation. Moscow; 2023. pp. 20-21. (In Russ.)

3. Sechko EA, Romanenkova EM, Eremina IA. et al. The role of specific pancreatic antibodies in the differential diagnosis of complete clinical and laboratory remission of type 1 diabetes mellitus and MODY in children. Diabetes mellitus. 2022;25(5):449-457. (In Russ.) doi: https://doi.org/10.14341/DM12921

4. Dedov II, Shestakova MV, Vikulova OK, et al. Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal register of diabetes mellitus for the period 2010-2022. Diabetes mellitus. 2023;26(2):104-123. (In Russ.) doi: https://doi.org/10.14341/DM13035

5. Laptev DN, Bezlepkina OB, Sheshko EL, et al. The main epidemiological indicators of type 1 diabetes in children in the Russian Federation for 2014-2023. Problems of Endocrinology. 2024;70(5):76-83. (In Russ.) doi: https://doi.org/10.14341/probl13515

6. Ogle GD, James S, Dabelea D, et al. Global estimates of incidence of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Atlas, 10th edition. Diabetes Res Clin Pract. 2022;183:109083. doi: https://doi.org/10.1016/j.diabres.2021.109083

7. Gregory GA, Robinson TIG, Linklater SE, et al. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol. 2022;10(10):741-760. doi: https://doi.org/10.1016/S2213-8587(22)00218-2

8. Knip M. Type 1 diabetes in Finland: past, present, and future. Lancet Diabetes Endocrinol. 2021;9(5):259-260. doi: https://doi.org/10.1016/S2213-8587(21)00074-7

9. Li Y, Qian K, Wu D, et al. Incidence of Childhood Type 1 Diabetes in Beijing During 2011-2020 and Predicted Incidence for 2025-2035: A Multicenter, Hospitalization-Based Study. Diabetes Ther. 2023;14(3):519-529. doi: https://doi.org/10.1007/s13300-023-01367-8

10. Manuwald U, Schoffer O, Kugler J, et al. Trends in incidence and prevalence of type 1 diabetes between 1999 and 2019 based on the Childhood Diabetes Registry of Saxony, Germany. PLoS One. 2021;16(12):e0262171. doi: https://doi.org/10.1371/journal.pone.0262171

11. Wändell PE, Carlsson AC. Time trends and gender differences in incidence and prevalence of type 1 diabetes in Sweden. Curr Diabetes Rev. 2013;9(4):342-349. doi: https://doi.org/10.2174/15733998113099990064

12. Patterson CC, Harjutsalo V, Rosenbauer J, et al. Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989-2013: a multicentre prospective registration study. Diabetologia. 2019;62(3):408-417. doi: https://doi.org/10.1007/s00125-018-4763-3

13. McKenna A, O’Regan M, Ryder K, Fitzgerald H, Hoey H, Roche E. Incidence of childhood type 1 diabetes mellitus in Ireland remains high but no longer rising. Acta Paediatr. 2021;110(7):2142-2148. doi: https://doi.org/10.1111/apa.15836

14. Libman I, Haynes A, Lyons S, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2022;23(8):1160-1174. doi: https://doi.org/10.1111/pedi.13454

15. Dedov II, Shestakova MV, Peterkova VA, et al. Diabetes mellitus in children and adolescents according to the Federal diabetes registry in the Russian Federation: dynamics of major epidemiological characteristics for 2013–2016. Diabetes mellitus. 2017;20(6):392-402. (In Russ.) doi: https://doi.org/10.14341/DM9460

16. Petryaykina EE, Laptev DN, Vorontsova IG, et al. Diabetes mellitus type 1 in children and adolescents in Moscow. Data from the Moscow Segment of the Federal Register of Diabetic Patients 2015–2020. Problems of Endocrinology. 2021;67(6):113-123. (In Russ.) doi: https://doi.org/10.14341/probl12795

17. Tuomilehto J, Ogle GD, Lund-Blix NA, Stene LC. Update on Worldwide Trends in Occurrence of Childhood Type 1 Diabetes in 2020. Pediatr Endocrinol Rev. 2020;17(Suppl 1):198-209. doi: https://doi.org/10.17458/per.vol17.2020.tol.epidemiologychildtype1diabetes

18. Parviainen A, But A, Siljander H, et al. Decreased Incidence of Type 1 Diabetes in Young Finnish Children. Diabetes Care. 2020;43(12):2953-2958. doi: https://doi.org/10.2337/dc20-0604

19. Abramov DD, Dedov II, Haitov RM, et al. Comparison of the contribution of the HLA system and other immune response genes to the development of genetic predisposition to type 1 diabetes mellitus. Immunologiya. 2012;33(1):4-6. (In Russ.)

20. Titovich EV, Kuraeva TL, Danilova GI, et al. Association of type 1 diabetes mellitus (DM1) with polymorphous alleles of class II HLA genes in Yakutian and Russian populations. Diabetes mellitus. 2009;12(3):26-32. (In Russ.) doi: https://doi.org/10.14341/2072-0351-5448

21. Dedov II, Shestakova MV, Kuraeva TV, et al. Nozologicheskaya geterogennost’, molekulyarnaya genetika i immunologiya autoimmunnogo saharnogo diabeta. Vestnik Rossijskoj Akademii Medicinskih Nauk. 2015;70(2):132-139. (In Russ.) doi: https://doi.org/10.15690/vramn.v70i2.1305

22. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet. 2014;383(9911):69-82. doi: https://doi.org/10.1016/S0140-6736(13)60591-7

23. Kamrath C, Rosenbauer J, Eckert AJ, et al. Incidence of Type 1 Diabetes in Children and Adolescents During the COVID-19 Pandemic in Germany: Results From the DPV Registry. Diabetes Care. 2022;45(8):1762-1771. doi: https://doi.org/10.2337/dc21-0969

24. Shadrina EM, Chernyak IY, Golovenko IM, et al. The COVID-19 pandemic and the incidence of type 1 diabetes in children in the Krasnodar Territory. Eurasian Union of Scientists. Series: medical, biological and chemical sciences. 2023;3-1(104):35–42. (In Russ.) doi: https://doi.org/10.31618/ESU.2413-9335.2023.4.104.1.1784