Endocrine Abstracts

Introduction: Analysis of epidemiologic patterns in diabetes helps with understanding of etiology, natural history and current and future needs. Bangladesh is a low-middle-income, densely populated country where there is limited information regarding incidence of childhood diabetes.

Aim: To assess the type of diabetes in children and young adults in Dhaka, Bangladesh, from July 2011 until June 2016, and estimate minimum incidence of type 1 diabetes (T1D).

Methods: Retrospective study using clinical records from Diabetic Association of Bangladesh (BADAS) clinics in Dhaka and affiliated satellite centers in other districts. Subjects under 25 years (y) diagnosed in the study period were identified. Diabetes type was classified according to clinical evaluation. Demographic information was obtained from the 2011 population census and extrapolated using the estimated growth rate. Incidence was calculated for the area surrounding the main clinics (Dhaka District) to minimize any ascertainment bias.

Results: Were identified 2347 subjects. Type of diabetes was more fully characterized for those <18 years (1634 cases), and showed 1437 (87.9%) T1D, 151 (9.2%) type 2, 23 fibrocalculous pancreatic diabetes (1.4%), 5 (0.3%) neonatal, 18 (1.1%) other types. For T1D incidence estimation a total of 526 subjects were ascertained. The mean Dhaka district incidence rate for subjects <25 y was 1.24/100 000 per y (males 0.92, females 1.71) and 0.96/100 000 for <15y (males 0.63, females 1.55). By age group, incidence/100 000 was 0.27 (0–4y), 0.60 (5–9y), 2.46 (10–14y), 1.86 (15–19y), 1.44 (20–24y). No secondary ascertainment could be done, but ascertainment in Dhaka Division was estimated to be at least 95%.

Discussion: The support to BADAS by the Changing Diabetes in Children and IDF Life for a Child Programs have centralized care and permitted tracking of diabetes cases in young people in Bangladesh. T1D is commonest, but other forms occur which could benefit from different management: further typology studies are warranted. T1D had a female preponderance. Peak T1D onset is at 10–14 y, as in developed nations.