Mary Burden

Comparative incidence of Type I diabetes in children aged under 15 years from South Asian and White or Other ethnic backgrounds in Leicestershire, UK, 1989 to 1998.

Abstract.Aims/hypothesis: Estimates of incidence of Type I (insulin-dependent) diabetes mellitus in childhood populations vary around the world. This study aimed to estimate and compare the incidence of Type I diabetes in Leicestershire of children of South Asian and White or Other ethnic backgrounds. Methods: All new cases of childhood-onset Type I diabetes diagnosed before 15 years of age in Leicestershire during the period 1989–98 were studied. Population data for Leicestershire from the 1991 census was used. Ethnicity was assigned to all children in the study according to their surnames. Incidence rates (95 %-Confidence limits) for the South Asian and white or other ethnic group were estimated and compared. Results: Over the 10-year period, 46 South Asian children and 263 children who were white or from another ethnic group fulfilled the criteria for inclusion in the study. Crude incidence rates per 100 000 person-years were 19.2 (12.0, 29.1) girls and 20.3 (13.0, 30.3) boys for South Asians and 17.7 (14.8, 21.1) girls and 17.7 (14.8, 20.9) boys for whites/others. Age and sex-specific rates were higher for South Asians over 5 years of age but differences were not statistically significant. Conclusion/interpretation: Type I diabetes incidence rates for South Asian children in Leicestershire were very similar to those for children who were in the white/other ethnic group, in contrast to very low rates reported from Asia. The convergence of rates for South Asians with other ethnic groups in Leicestershire suggests that environmental factors are more important than genetic predisposition in causing Type I diabetes in people of South Asian ethnic background. [Diabetologia (2001) 44 [Suppl 3]: B 32–B 36]

The Mortality of Elderly People with Diabetes

To assess the full effect of diabetes on survival in elderly subjects, residents of Melton Mowbray aged 65, 70, 75, 80, and 85 years were screened by glucose tolerance test and followed up for 4.5 years. Death occurred in 56 of 520 normal subjects, 9 of 44 subjects with impaired glucose tolerance, 7 of 19 newly diagnosed diabetic subjects, and 27 of 52 known diabetic subjects. Diabetic subjects were 4.5 times (95% confidence interval 2.9‐7.0) more likely to die than subjects with normal glucose tolerance. Thus elderly diabetic subjects have a substantially increased risk of death compared to their normal glucose tolerant peers.

What is the prevalence of visual impairment in the general and diabetic populations: are there ethnic and gender differences?

Aims To estimate the prevalence of blindness and partial sight in the general and diabetic populations and to measure the impact of ethnicity and gender on these rates.

Screening for Type 2 diabetes mellitus in the UK Indo-Asian population.

Aims Type 2 diabetes mellitus (DM) has a high prevalence in Asian subjects. A simple method of screening using self‐testing for postprandial glycosuria achieved a good response rate and a sensitivity which compared favourably to more expensive and invasive methods in a semirural Caucasian population. We examined its effectiveness in Asian subjects.

Near patient testing for glycated haemoglobin in people with Type 2 diabetes mellitus managed in primary care: acceptability and satisfaction

Aims  To assess the acceptability of and satisfaction with near patient testing for glycated haemoglobin in primary care in patients and health professionals.

The American Diabetes Association Screening Questionnaire for Diabetes: Is it worthwhile in the U.K.?

The American Diabetes Association (ADA) screening recommendations include a questionnaire to limit the need for blood testing (1), thus reducing expense and the risks of exposure to blood. We therefore performed a retrospective study to investigate whether this method of screening was appropriate for use in the U.K. We have compared questionnaire responses to random blood glucose concentration (RBG) using Boehringer Mannheim 1-44, Reflolux with rigorous internal and external quality control. (The external quality control results for all screening staff were < 5% coefficient of variation.) The ADA suggested a score of >5 (maximum 22) carried a high risk of diabetes. The general population of Leicestershire was invited to attend a health promotion exhibition, and we compared the ADA questionnaire score to their RBG. Risk of diabetes was considered to be RBG >6.5 mM. Of the 540 people screened with RBG values, 10 were from people with known diabetes who were excluded from further analysis. Some did not complete the questionnaire mainly because of language difficulties; however, 383 questionnaires and RBG values could be matched. Of the matches, 50 had elevated RBG estimations, and of these, Table 1—RBG concentrations of screening participants

IDDM and celiac disease.

A n association between celiac disease and diabetes has been widely reported both in clinical surveys and in case histories (1-7). We studied this relationship, the extent of the association between celiac disease and diabetes, and whether this association was with insulin-dependent diabetes mellitus (IDDM). Leicestershire has a population of 867,521 (1991 census) and is unusual in that the Health Authority follows geographical boundaries. This makes establishing population-based registers possible. Leicestershire has a register of childhood diabetes dating from the 1940s (8). This was extended in 1983 to include all people taking insulin in Leicestershire who had non-insulindependent diabetes mellitus and IDDM. Ascertainment previously has been found to be >95%. The celiac disease register was started in 1989. The two registers are similar in their methods of ascertainment and were derived from multiple sources. The insulin-taking register was separately obtained from consultant records, patient associations, general practitioners, and diabetes specialist nurse records (8). The celiac register (9) was obtained from consultant records, patient associations, general practitioners, histopathological records, and dietitian records. Ascertainment was calculated using capture-mark-recapture methodology (10).