Birth and childhood weight pose as two of the risk factors in developing diabetes. As Goran and Sothern wrote on their book: “There is ample evidence that birth weight and weight in early infancy have an inverse association, whereas childhood and adolescent BMIs have a positive association with risk of developing diabetes. The association with birth weight is thought to reflect that inadequate nutrition in utero programs ‘the fetus to develop resistance to insulin-stimulated uptake of glucose later in life” – a thrifty phenotype. ” Goran and Sothern, 2006, 9)
Projected annual incidence, prevalence and future prevalence assumptions serve as an advantageous overture in the epidemiological study of childhood diabetes. These studies suggest an increasing awareness and proper management in dealing with diabetic children. One of the scenarios built during diabetic cases projection was called the ‘key reference scenario’ for 2000-2025 Dabelea and Georgeanna, 2008). This illustrates a setting where population growth, increase in incidence, and reduction in mortality from year 2000 as the baseline year, and with an expected parameters control.
The second setting, called simplistic scenario demonstrates a situation where there is no population growth of children at risk of type 1 diabetes, as well as no changes in either morbidity or mortality rate. This alternative indicated that an unchanged demographics and population number result in epidemiological equilibrium, thus morbidity rates reciprocates mortality rates. But when a change in one or more parameters occurs, epidemiological disequilibrium occurs, with a stable prevalence rate, and an equal annual and mortality rate.
The last scenario reflects a setting where there is an assumptive growth of at risk population but breaks in incidence and mortality rates are halted. . The alteration between the first scenario and this scenario estimates future changes in prevalence that is credited from demography and background population changes. Alternative scenarios were created to roughly calculate and explore the effects of epidemiological equilibrium and disequilibrium.
Polydipsia or excessive thirst, polyuria or excessive urination and weight loss are generally the classic epidemiological triad of type 1 childhood diabetes. The word poly indicates “too much”. The onset of childhood diabetes is usually abrupt between ages 5 to 7 during early childhood and at puberty during adolescence. Marked weight loss is very significant during assessment since it is often the initial sign of diabetes among children. As for polyuria, it is reflected on the child’s bedwetting.
Glycosuria or presence of glucose in the urine, polyphagia, pruritis or skin rashes and mood changes are symptoms adjunct to the three pathological signs of childhood diabetes. Pruritis can rarely result to necrobiosis lipoidica characterized by yellow plaques in the skin, which often scale, crust or ulcerate. Epidemiologic triangle is the linkage and interaction of environmental exposure and factors, characteristics or risks-causing disease and the corresponding prevention levels regarding the disease.
Since epidemiologic triangle of diseases usually has a host or exogenous factors, vectors or means of acquisition and environment, for type 1 childhood diabetes, host is immune-mediated destruction of B-cells leading to lack of insulin production and other viral agents associated with this, vector is glucose in the blood circulation reaching the pancreas will not be absorbed and utilized and environmental factors are conspiracy from genetic background, body composition changes, and environmental determinants causing metabolic processes to decompensate.
Current studies have concluded that prior to diagnosis, type 1 diabetic children experience mild hyperglycemia and other symptoms accompanied by ketoacidosis. Diabetic Ketoacidosis DKA) is a condition where blood glucose concentration is alarmingly beyond normal parameters and is normally associated with type 1 diabetes.