Shifting Seasonal Pattern of Type 1 Diabetes Diagnosis and Diabetic Ketoacidosis at Diagnosis Towards Warm Seasons in Children and Adolescents During 2011-2020: A Single Center Experience in Iran.
Background: The seasonality of type 1 diabetes and diabetic ketoacidosis at diagnosis have been reported in most areas of the world, but there are few reports from north of Iran. Objectives: Considering the connection between type 1 diabetes mellitus (T1DM) diagnosis and environmental influences, th...
| Publicado en: | Journal of Pediatrics Review Vol. 14; no. 2; pp. 163 - 176 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mazandaran University of Medical Sciences
Apr2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195157045&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195157045 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23224398 HC3Y jtl: Journal of Pediatrics Review issn: 23224398 maglogo: N pubinfo: dt: Apr2026 vid: 14 iid: 2 pid: 45683 pub: Mazandaran University of Medical Sciences artinfo: ui: 195157045 195157045 195157045 10.32598/jpr.14.2.1073.4 195157045 ppf: 163 ppct: 13 formats: fmt: @attributes: type: P tig: atl: Shifting Seasonal Pattern of Type 1 Diabetes Diagnosis and Diabetic Ketoacidosis at Diagnosis Towards Warm Seasons in Children and Adolescents During 2011-2020: A Single Center Experience in Iran. aug: au: Ghazaiean, Mobin Najafi, Behnam Zamanfar, Daniel affil: Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran sug: subj: Diabetes Mellitus, Type 1 Diagnosis Diabetes Mellitus, Type 1 Diagnosis Diabetic Ketoacidosis Diagnosis Diabetic Ketoacidosis Diagnosis Diabetes Mellitus, Type 1 Trends Diabetic Ketoacidosis Trends Seasons Iran Age Factors Sex Factors Human Male Female Infant, Newborn Infant Child, Preschool Child Adolescence Iran Retrospective Design Medical Records Record Review Comparative Studies Interviews Hospitals, Pediatric Mann-Whitney U Test Kendall's tau Trend Studies Chi Square Test Fisher's Exact Test T-Tests Descriptive Statistics Data Analysis Software Confidence Intervals Climate Change Life Style Changes Infant, Newborn: birth-1 month Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Male Female ab: Background: The seasonality of type 1 diabetes and diabetic ketoacidosis at diagnosis have been reported in most areas of the world, but there are few reports from north of Iran. Objectives: Considering the connection between type 1 diabetes mellitus (T1DM) diagnosis and environmental influences, this study aimed to evaluate the seasonal trends of T1DM and diabetic ketoacidosis (DKA) at the time of diagnosis over a 10-year period. Methods: In a retrospective study spanning two 5-year periods, 221 pediatric patients with T1DM were analyzed. They were categorized into two groups: Group 1 comprised those diagnosed from 2011 to 2015, while group 2 consisted of patients diagnosed from 2016 to 2020 (pre-COVID-19 quarantine). Changes in type 1 diabetes onset and DKA at diagnosis were assessed using Mann-Kendall trend test. Monthly and seasonal variation of type 1 diabetes and DKA at diagnosis were assessed over a 10-year period comparing two 5-year intervals. The data were analyzed using STATA software, version 17. Results: Of the 221 individuals, 101(45.7%) and 120(54.3%) patients were diagnosed in group 1 and 2, respectively. The Mann-Kendall trend test revealed significant changes in both T1DM onset and DKA at diagnosis over the period 2011-2020 (tau=0.6138, P=0.0191) and (tau=0.582, P=0.0287), respectively. The increase in T1DM onset occurred in spring and June during the second period. The mean age at diagnosis was 7.2±4 years, with group 1 (6.63, 95% CI, 5.75%, 7.51%) being younger than group 2 (7.58, 95% CI, 6.83%, 8.33%). The frequency of adolescent patients significantly increased in the group 2 compared to group 1 (71.2% vs 28.8%, P=0.04). In both periods, there was a predominance of female sex, and the seasonal pattern of female sex shifted towards spring and summer in group 2. The frequency of DKA at presentation was 37.1% (95% CI, 30.9%, 43.7%) over a ten-year period, with 32.7% (95% CI, 24.2%, 42.4%) in group 1 and 41% (95% CI, 32.4%, 50%) in group 2 (P=0.35). An analysis of the seasonal pattern of initial presentations with DKA indicates that group 1 patients exhibited the highest rate of DKA in the summer and autumn, with the lowest rate in the spring. Meanwhile, group 2 patients displayed that DKA at diagnosis was highest in summer and lowest in autumn. Conclusions: The onset of T1DM and DKA shows a shift toward warmer seasons. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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