The significance of certain epidemiological variants in the genesis of juvenile insulin-dependent diabetes mellitus--the need for a global program of co-operation.

Abstract

Published data from literature show a two-to four-fold increase in the incidence of JIDDM, in the Western hemisphere over the past decade (5% to 10-20%). WHO Expert Committee Technical Report Series No. 646 (1980) gives the risk of development of diabetes in the first two decades of life, in the sub-populations of Europe and North America, as 0.1% to 0.3%. In Japan, it is stated to be less than 0.02%; in Tamil Nadu, India, we have calculated the risk to be less than 0.01%. The incidence of JIDDM amongst diabetics in urban Southern India has remained low and static in the last decade; 0.8% and 0.84% in 1973 and 1981 respectively. This is so, despite the fact that infant and perinatal mortality rates over the past two decades have registered a sharp decline in our area. Childhood diabetes and its complications have not shown an uptrend in hospital admissions or infant mortality analysis. It is speculative that our ethnic group is lacks the genetic factor, Bf F1 (which is strongly linked with HLA B18 and IDDM) and the increased association of S1. It remains to be elucidated whether the increased susceptibility to JIDDM of Caucasian children may be associated with a genetic factor or some other exogenous factor, Such as a nutritional factor or virus infection. A plea is made to exchange groups of diabetic children and study the "behavior" of their diabetes under different environments.