Correlating the global increase in type 1 diabetes incidence across age groups with national economic prosperity: A systematic review

BACKGROUND The global epidemiology of type 1 diabetes(T1D)is not yet well known,as no precise data are available from many countries.T1D is,however,characterized by an important variation in incidences among countries and a dramatic increase of these incidences during the last decades,predominantly in younger children.In the United States and Europe,the increase has been associated with the gross domestic product(GDP)per capita.In our previous systematic review,geographical variation of incidence was correlated with socio-economic factors.AIM To investigate variation in the incidence of T1D in age categories and search to what extent these variations correlated with the GDP per capita.METHODS A systematic review was performed to retrieve information about the global incidence of T1D among those younger than 14 years of age.The study was carried out according to the PRISMA recommendations.For the analysis,the incidence was organized in the periods:1975-1999 and 2000-2017.We searched the incidence of T1D in the age-groups 0-4,5-9 and 10-14.We compared the incidences in countries for which information was available for the two periods.We obtained the GDP from the World Bank.We analysed the relationship between the incidence of T1D with the GDP in countries reporting data at the national level.RESULTS We retrieved information for 84 out of 194 countries around the world.We found a wide geographic variation in the incidence of T1D and a worldwide increase during the two periods.The largest contribution to this increase was observed in the youngest group of children with T1D,with a relative increase of almost double when comparing the two periods(P value=2.5×e-5).Twenty-six countries had information on the incidence of T1D at the national level for the two periods.There was a positive correlation between GDP and the incidence of T1D in both periods(Spearman correlation=0.52 from 1975-1999 and Spearman correlation=0.53 from 2000-2017).CONCLUSION The incidence increase was higher in the youngest group(0-4 years of age),and the highest incidences of T1D were found in wealthier countries.

Sex and age classes of prey items (rats/mice) in the diet of the Barn Owl (Tyto alba) in Sindh,Pakistan

Barn Owl (Tyto alba) pellets were collected from nine locations and two districts of Sindh,Pakistan and 937 prey items were recovered from 619 pellets.Rats/mice (59.6%) were the most dominant food items consumed by the Barn Owl.Shrews (22.3%),bats (1.3%),birds (12.0%),insects (1.3%),frogs (2.2%) and plant materials (1.3%) were found in their diet as well.Study of the pelvic girdle bones of rats/mice,used only for sexing,proved to be a useful device in population dynamics.In the pelvic bone,pelvic symphysis is found only in female rats/mice developed as a result of sex hormones that occur during gestation.Among the diet of rats/mice,males were found to be significantly dominant.Tooth wear patterns on the occlusal surfaces of molariform teeth of the rats/mice were found to provide an effective criterion for establishing age classes of rats/mice.In the present study,adult rats/mice were found to be dominant over sub-adults and old adults.ANOVA showed significant differences in the number of rats/mice and shrews (prey items) and the other prey items/plant materials in the diet of Barn Owls in the district Thatta and district Karachi.Chi-square test disclosed non-significant differences in age and sex categories.