- 小児・思春期においても、糖尿病の診断基準、糖尿病の成因分類は成人と同様である 。
- 近年の報告では、わが国の小児（14歳以下）1型糖尿病の発症率は、約1.5～2.5（対10万人/年）であり、発症率のピークは11～12歳である 。
- 近年の報告ではわが国の小児2型糖尿病の発症率は、2.57～3.57（対10万人/年）である。小学生では0.75～2.00であるが、中学生では5.05～6.65である 。
- ②75gOGTT 2時間値≧200mg/dL
- ④HbA1c(NGSP) ≧6.5％
|1:||日本糖尿病学会糖尿病診断基準に関する調査検討委員会. 糖尿病の分類と診断基準に関する委員会報告（国際標準化対応版）.糖尿病 2012; 55: 494.|
|2:||Incidence of Type 1 diabetes mellitus in children aged 0-14 in Japan, 1986-1990, including an analysis for seasonality of onset and month of birth: JDS study. The Data Committee for Childhood Diabetes of the Japan Diabetes Society (JDS).|
著者: K Kida, G Mimura, T Ito, K Murakami, I Ashkenazi, Z LaronDiabet Med. 2000 Jan;17(1):59-63.
雑誌名: Diabet Med. 2000 Jan;17(1):59-63.
Abstract/Text AIMS: To detect the incidence of childhood Type 1 diabetes mellitus (DM) (0-14 years) in Japan and to find out whether there is a seasonal pattern in the onset of disease and month of birth of children with diabetes.
METHODS: Ascertained data for the period 1986-1990 could be collected in 35 out of 47 local government areas representing 69.4% of the childhood population (aged 0-14 years) of Japan.
RESULTS: A total of 1,260 children with Type 1 DM were identified (738 girls, 522 boys). With age there was a progressive increase in incidence from 0.7 to 2.1/10(5) in boys and from 0.6 to 3.5/10(5) in girls. With the exception of 1987, when a coxsackie B3 virus epidemic was registered, no seasonal variation in the month of onset was observed, nor was a seasonal pattern of the month of birth registered in this cohort.
CONCLUSIONS: Compared to European countries, the USA and Israel, the Japanese cohort of children with diabetes presents the following differences: the incidence is much lower, there is a preponderance of girls and there is (with one exception) no seasonal pattern.
|3:||Descriptive epidemiology of IDDM in Hokkaido, Japan: the Childhood IDDM Hokkaido Registry.|
著者: N Matsuura, K Fukuda, A Okuno, S Harada, N Fukushima, A Koike, Y Ito, T HotsuboDiabetes Care. 1998 Oct;21(10):1632-6.
雑誌名: Diabetes Care. 1998 Oct;21(10):1632-6.
Abstract/Text OBJECTIVE: To identify the incidence of IDDM with regard to sex, age, family history of diabetes, season, and 5-year period of childhood IDDM among children ages 0-14 years from a population-based epidemiological study in Hokkaido, Japan, from 1973 to 1992.
RESEARCH DESIGN AND METHODS: Registration of all new IDDM cases in Hokkaido was conducted by the Childhood IDDM Hokkaido Registry Study Group from 1973 to 1992. The cases were selected from among 1) patients who were admitted to the member hospitals of the study group, 2) patients who answered a questionnaire distributed to hospitals and diabetic clinics throughout Hokkaido, and 3) patients whose cases were recorded in free-treatment medical records of urban and rural districts. The case ascertainment rate was estimated to be 100%. Differences in incidence with regard to sex, age, family history of diabetes, season, and year period were analyzed by the Poisson regression analysis by GENMOD.
RESULTS: During the 20-year period studied, 396 cases (181 boys, 215 girls) of abrupt-onset IDDM were registered. Statistically significant differences in annual incidence were found according to sex (female), age (8-14 years), history (having no diabetes in family), season (spring), and 5-year period.
CONCLUSIONS: This is the first population-based, long-term epidemiological study of childhood IDDM from Japan. We observed a significantly higher annual incidence (per 100,000/year) of IDDM in female subjects (1.81), older age-groups (2.25 for 8-14 years), subjects with no family history of diabetes (1.26), diabetes onset in the spring (2.20), and an increased trend over the 20 years. In addition, the heterogeneity of IDDM among Japanese children needs to be elucidated.
|4:||Lack of regional variation in IDDM risk in Japan. Japan IDDM Epidemiology Study Group.|
著者:Diabetes Care. 1993 May;16(5):796-800.
雑誌名: Diabetes Care. 1993 May;16(5):796-800.
Abstract/Text OBJECTIVE: To examine the intracountry variation of IDDM incidence in Japan and compare it with data from the British Isles and the U.S.
RESEARCH DESIGN AND METHODS: IDDM incidence was determined with a standardized registry approach in five geographically different areas in Japan (Hokkaido, Tokyo, Yokohama, Osaka, and Kagoshima) with a total at-risk population < 15 yr of age of 4.4 million. Data collection was completed under the guidelines of the World Health Organization DiaMond project.
RESULTS: The incidence and patterns of disease were remarkably similar across the five environmentally different areas. Incidence rates per 100,000 were very low and almost identical from northern to southern Japan (Hokkaido, 2.07; Tokyo, 1.65; Yokohama, 1.66; Osaka, 1.78; and Kagoshima, 1.93). This remarkably low intra-country variation of 0.4/100,000 stands in sharp contrast with the 13.0/100,000 regional variation in the British Isles and the 10.6/100,000 variation in the U.S.
CONCLUSIONS: The results suggest that the remarkable genetic homogeneity in Japan may produce uniformity of incidence.
|5:||Annual incidence and clinical characteristics of type 2 diabetes in children as detected by urine glucose screening in the Tokyo metropolitan area.|
著者: Tatsuhiko Urakami, Shigeki Kubota, Yoshikazu Nitadori, Kensuke Harada, Misao Owada, Teruo KitagawaDiabetes Care. 2005 Aug;28(8):1876-81.
雑誌名: Diabetes Care. 2005 Aug;28(8):1876-81.
Abstract/Text OBJECTIVE: This study investigates the annual incidence and clinical characteristics of type 2 diabetes among school-aged children as detected by urine glucose screening from 1974 to 2002 in the Tokyo metropolitan area.
RESEARCH DESIGN AND METHODS: In total, 8,812,356 school children were examined for glucosuria. Morning urine was used for the analysis. When the urine was positive for glucose, an oral glucose tolerance test was carried out to confirm diabetes.
RESULTS: In all, 232 students were identified to have type 2 diabetes. The overall annual incidence of type 2 diabetes was 2.63/100,000. The annual incidence after 1981 was significantly higher than that before 1980 (1.73 vs. 2.76/100,000, P < 0.0001). The annual incidence was significantly higher for junior high school students compared with primary school students (0.78 vs. 6.43/100,000, P < 0.0001). The overall male-to-female ratio of students with type 2 diabetes was 1.0:1.19 (P = 0.296), but it was 1.0:1.56 (P = 0.278) for primary school students. Overall, 83.4% of children with diabetes were obese (> or = 20% overweight). However, nonobese girls (<20% overweight) with diabetes accounted for 23.0% of the patients, whereas markedly obese boys (> or = 40% overweight) accounted for 61.5% of the patients. The frequency of a family history of type 2 diabetes in second- and first-degree relatives was 56.5%.
CONCLUSIONS: We confirmed that the incidence of young people with type 2 diabetes increased after 1981 in the Tokyo metropolitan area. The increase in the frequency of this disorder seemed to be strongly related to an increasing prevalence of obesity. Age and genetic susceptibility may be associated with the occurrence of type 2 diabetes.
|6:||Urine glucose screening program at schools in Japan to detect children with diabetes and its outcome-incidence and clinical characteristics of childhood type 2 diabetes in Japan.|
著者: Tatsuhiko Urakami, Shigeo Morimoto, Yoshikazu Nitadori, Kensuke Harada, Misao Owada, Teruo KitagawaPediatr Res. 2007 Feb;61(2):141-5. doi: 10.1203/pdr.0b0･･･
雑誌名: Pediatr Res. 2007 Feb;61(2):141-5. doi: 10.1203/pdr.0b013e31802d8a69.
Abstract/Text A large number of children with type 2 diabetes have been detected by a urine glucose screening program conducted at schools in Japan since 1975. The incidence of type 2 diabetes in children has increased over the last three decades, and the incidence is estimated to be approximately 3.0/100,000/y during 1975-2000. The incidence of type 2 diabetes in junior high school children is three to six times higher than that in primary school children. More than 80% of children with type 2 diabetes are obese, and boys are more likely to be obese than girls. It is speculated that the increase in the incidence of childhood type 2 diabetes over the years may be a consequence of the increase in the frequency of obesity in school children. However, this trend of increasing incidence of childhood obesity has recently become weaker, and perhaps as a consequence, the incidence of type 2 diabetes has also decreased after the year 2000 in some cities of Japan. Improved attention to physical activity and eating habits among young people may be responsible at least in part to the decrease in the incidence of type 2 diabetes noted in recent years in big cities of Japan.