Insulin-requiring diabetes up in young children

Updated 05 February 2013
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Insulin-requiring diabetes up in young children

THE number of cases of insulin-requiring type 1 diabetes rose sharply in children under the age of five in Philadelphia over a two decade span, paralleling increases seen across the United States and in Europe, according to a US study.
Researchers whose work appeared in the journal Diabetes Care found that the number of children under five diagnosed with type 1 diabetes increased 70 percent in 2005 from 1985, when a registry of such patients was begun.
The number of diagnosed cases among all children up to age 14 rose by 29 percent.
“Why are we seeing this large increase in type 1 diabetes in very young children? Unfortunately, the answer is we don’t know,” said lead author Terri Lipman, a professor at the University of Pennsylvania School of Nursing.
Of the two most common forms of diabetes, type 2 typically affects adults who can still produce insulin, but whose bodies cannot use the hormone to regulate blood sugar. Type 1, previously known as juvenile diabetes, typically strikes children whose immune systems have killed off insulin-producing cells in the pancreas. The disease is usually fatal if left untreated.
In 1985, according to a registry of Philadelphia children diagnosed with type 1 diabetes, 13.4 out of every 100,000 children in Philadelphia was newly diagnosed with the disease. In 2004, the rate was 17.2 cases per 100,000.
Type 1 diabetics must take insulin, but many type 2 diabetics can control the disease with medications, diet and exercise.
Type 1 diabetes tends to start in adolescence, but experts said parents need to be aware that toddlers and preschoolers are also susceptible, given the rising number of cases in very small children. Children from Chicago to Colorado to Finland have similarly increased rates of type 1 diabetes, though the cause eludes researchers.
“This young group is a mystery,” said Carol Levy, a type 1 diabetes specialist at Mount Sinai Hospital in New York who was not involved in the study.
“Make sure your child has a healthy lifestyle and maintains normal body weight, whether that’s a guarantee we’re going to reduce risk, we don’t know at this point.
Several theories vie to explain the recent rise in diabetes among youth, including vitamin D deficiencies, lack of breastfeeding and over-hygienic environments that might cause the immune system to backfire.
“The data is controversial, so that’s why I’m certainly very reluctant to propose a theory when nothing has been proven,” Lipman told Reuters Health.
It is important to be aware of the symptoms of diabetes, which can include extreme thirst, bed wetting or accidents in toilet-trained children or excessively wet diapers in babies, said Lori Laffel, of the Joslin Diabetes Center in Boston.
By the time the disease is diagnosed, many infants and toddlers are very sick and the degree of illness tends to be more severe the younger the patient, experts noted.
“The young child isn’t able to talk about symptoms,” Laffel said. “A young child may be in diapers, you may not notice because diapers are often wet.”


UN: Global fight against AIDS is at ‘precarious point’

Updated 18 July 2018
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UN: Global fight against AIDS is at ‘precarious point’

  • ‘There are miles to go in the journey to end the AIDS epidemic. Time is running out’
  • Since the start of the AIDS epidemic in the 1980s, more than 77 million people have become infected with HIV

LONDON: Complacency is starting to stall the fight against the global AIDS epidemic, with the pace of progress not matching what is needed, the United Nations warned on Wednesday.
The United Nations’ HIV/AIDS body UNAIDS said in an update report that the fight was at a “precarious point” and while deaths were falling and treatment rates rising, rates of new HIV infections threatened to derail efforts to defeat the disease.
“The world is slipping off track. The promises made to society’s most vulnerable individuals are not being kept,” the report said. “There are miles to go in the journey to end the AIDS epidemic. Time is running out.”
Michel Sidibe, executive director of UNAIDS, noted in the report’s foreword that there had been great progress in reducing deaths from AIDS and in getting a record number of people worldwide into treatment with antiretroviral drugs.
The report said an estimated 21.7 million of the 37 million people who have the human immunodeficiency virus (HIV) that causes AIDS were on treatment in 2017, five and a half times more than a decade ago.
This rapid and sustained increase in people getting treatment helped drive a 34 percent drop in AIDS-related deaths from 2010 to 2017. AIDS deaths in 2017 were the lowest this century, at fewer than a million people, the report said.
But Sidibe also pointed to what he said were “crisis” situations in preventing the spread of HIV, and in securing sustained funding.
“The success in saving lives has not been matched with equal success in reducing new HIV infections,” he said. “New HIV infections are not falling fast enough. HIV prevention services are not being provided on an adequate scale ... and are not reaching the people who need them the most.”
Sidibe said a failure to halt new infections among children was a big worry.
“I am distressed by the fact that in 2017, 180,000 children became infected with HIV, far from the 2018 target of eliminating new HIV infections among children,” he wrote.
Data in the report showed that overall among adults and children worldwide, some 1.8 million people became newly infected with HIV in 2017.
Since the start of the AIDS epidemic in the 1980s, more than 77 million people have become infected with HIV. Almost half of them — 35.4 million — have died of AIDS.
The report said that at the end of 2017, $21.3 billion was available for the AIDS response in low- and middle-income countries. More than half of that came from domestic funding sources rather than international donors. UNAIDS estimates that $26.2 billion will be needed to fund the AIDS fight in 2020.
“There is a funding crisis,” Sidibe said. While global AIDS resources rose in 2017, there was still a 20 percent shortfall between what is needed and what is available.
Such a shortfall will be “catastrophic” for countries that rely on international assistance to fight AIDS, Sidibe said.