Diabetes is a very common and prevalent disease, and type 1 diabetes is one of them. Most people in general are under the impression that people with type 1 diabetes need lifelong insulin therapy. It is medically accepted that type 1 diabetes is caused by genetic and environmental factors that damage the pancreatic islet β-cells, causing an absolute deficiency of insulin, meaning that the patient has little or almost no insulin.
Patients with type 1 diabetes often have significantly elevated blood glucose, with the clinical manifestation of “three more and one less” symptoms, namely polyuria, thirst, polyphagia, polyphagia and lethargy, and are prone to the acute complication of diabetic ketoacidosis, so patients often need insulin injections to stay alive.
It was previously thought that type 1 diabetes was mainly seen in children, although people of all ages can have type 1 diabetes. Epidemiologic data on type 1 diabetes are available from developed countries abroad, and the prevalence of type 1 diabetes in the Chinese pediatric population was approximately 0.51 per 100,000 person-years between 1985 and 1994, one of the lowest rates in the world. The prevalence of type 1 diabetes in adults is also high, but the prevalence of type 1 diabetes in people older than 20 years of age is unknown.
The country is so large that there is no population-wide (i.e., all ages) data on the prevalence of type 1 diabetes. Until recently, a study was done under the auspices of the Chinese Medical Association, giving us our own epidemiologic data on type 1 diabetes and the incidence and prevalence of type 1 diabetes in people of all ages, which is useful for disease prevention and treatment.
Analysis of the type 1 diabetes prevalence survey in all age groups in China between 2010 and 2013 showed that the study looked at different regions of China, including the northeast, north, northwest, central and south, and east, involving a total of 133 million people, or about 10% of the Chinese population, with 6% of the population under the age of 15. The survey collected more than 20,000 patients and identified 5018 new cases of type 1 diabetes, of whom 1239 were aged 0-14 years, 1799 were aged 15-29 years, 1980 were aged 30 years or older, and about 65.3% were aged 20 years or older, and 2755 patients (54.9%) were male.
The prevalence of type 1 diabetes by age group was as follows: 0.93/100,000 person-years for all ages, 1.90/100,000 person-years for children younger than 15 years, 1.02/100,000 person-years for those 15 to 29 years, and 0.51/100,000 person-years for those 30 years and older.
These data show that the peak incidence of type 1 diabetes in people younger than 15 years of age is between 10 and 14 years of age, with a higher incidence in girls than in boys, whereas for people older than 15 years of age, the incidence of type 1 diabetes declines gradually with increasing age. However, adults make up a large proportion of the population and therefore a large proportion of adult-onset patients, with an estimated national increase of more than 13,000 new patients with type 1 diabetes each year more than 9,000 of these are adults aged 15 years or older. The prevalence of type 1 diabetes in children under 15 years of age has increased rapidly over the past 20 years in China, but overall, China remains a country with a low prevalence of type 1 diabetes.
In addition, the study found a positive correlation between the prevalence of type 1 diabetes in children under 15 years of age and latitude, with a higher prevalence in the north and a lower prevalence in the south, with Lanzhou having the highest prevalence of type 1 diabetes among the 13 regions studied at 1.57 per 100,000 person-years, followed by Harbin, Wuhan, and Chengdu having the lowest, although no such correlation was found in the higher age groups. However, no such correlation was found in the higher age groups.
The pathogenesis of type 1 diabetes includes both genetic and environmental factors, but given that the incidence of type 1 diabetes has been increasing each year in recent years and that the growth of the disease cannot be explained exclusively by genetic factors, it is possible that environmental factors during the fetal, neonatal, and childhood periods play an important role. These environmental factors include high birth weight, early rapid growth and development, and early feeding practices such as milk feeding.
In addition, studies have found that viral infections may contribute to islet β-cell damage. Other factors, such as psychological stress and climate effects, may also accelerate disease progression, and vitamin D, temperature, and population density may influence the regional distribution of type 1 diabetes.
Internationally, the main prevention strategies for type 1 diabetes include:
- Avoiding environmental triggers, such as milk and cereals, and paying attention to supplementation with Omega-3 fatty acids or vitamin D;
- Use vaccines that target specific antibodies with the aim of inducing immune tolerance, that is, increasing the body’s ability to tolerate the relevant immune damaging factors;
- systemic immunotherapies that do not target a particular antigen, such as vaccines, immunosuppressants, and cellular therapies, which suppress the body’s immune capacity overall;
- Metabolic modifications, such as weight loss, control of caloric intake, and adherence to physical activity.
In conclusion, the incidence of type 1 diabetes has increased markedly in recent years, with a predisposition in children but a predominance in adults. The etiology is still poorly understood, and the associated risk factors are targets for disease prevention and treatment. As epidemiological studies and basic medical research continue, it is expected that effective prevention and treatment methods will be found.