{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T04:50:53Z","timestamp":1788324653557,"version":"build-2803163510"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the clinical incidence and characteristics of type 1 diabetes mellitus (T1DM) of children and adolescents at the time of initial diagnosis in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on all pediatric patients with newly diagnosed T1DM were retrospectively collected from 34 medical centers in 25 major cities in China from January 2015 to January 2020. Patients were classified into three age groups: &amp;lt;5 years, 5 to &amp;lt;10 years, and \u226510 years of age. The same patient population was also categorized into diabetic ketoacidosis (DKA) and non-DKA groups based on clinical criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean annual clinical incidence of T1DM was 3.16\/100,000 from the years 2015 to 2019. A total of 6,544 patients with newly diagnosed T1DM aged 0\u201316 years (median 7.84 \u00b1 3.8) were studied [ages &amp;lt;5 years (29.3%), 5 to &amp;lt;10 years (38.7%), and \u226510 years (32%)], 52.4% of them were women. In total, 90.5% of the cases were occurred in individuals without a family history. Patients had lower C-peptide (CP) and body mass index (BMI) z scores when compared with healthy children, 41.8% of them had measurable T1DM-related antibodies and 52.7% had DKA. Among all three age groups, the &amp;lt;5 years group had the lowest BMI z score, CP, and glycated hemoglobin (HbA1c) on average, while it had the highest incidence rate of DKA (56.9%). Compared to the non-DKA group, the DKA group was significantly younger, with a lower BMI z score and CP, higher antibody positive rate, HbA1c, and the rate of insulin pump therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The clinical incidence of T1DM in children and adolescents in China was 3.16\/100,000. Patients with DKA at the first diagnosis of T1DM have a worse \u03b2-cell function. Public health measures for the prevention and treatment of T1DM should focus on preschoolers (aged &amp;lt;5 years) in particular, considering the severity and the highest frequency of DKA in this age group. More efforts should be dedicated to early screening and diagnosis of the T1DM.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.888370","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T06:20:38Z","timestamp":1655274038000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical Incidence and Characteristics of Newly Diagnosed Type 1 Diabetes in Chinese Children and Adolescents: A Nationwide Registry Study of 34 Medical Centers"],"prefix":"10.3389","volume":"10","author":[{"given":"Guo-Hua","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan-Ping","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Wei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Xiu","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei-Hong","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Ping","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Lin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Fen","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The T1DM China Study Group for Children Adolescents","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"107842","DOI":"10.1016\/j.diabres.2019.107842","article-title":"Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: results from the international diabetes federation diabetes Atlas, 9th edition","volume":"157","author":"Patterson","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2741","DOI":"10.1007\/s00125-021-05571-8","article-title":"Type 1 diabetes in 2017: global estimates of incident and prevalent cases in children and adults","volume":"64","author":"Green","year":"2021","journal-title":"Diabetologia."},{"key":"B3","doi-asserted-by":"publisher","first-page":"198","DOI":"10.17458\/per.vol17.2020.tol.epidemiologychildtype1diabetes","article-title":"Update on worldwide trends in occurrence of childhood type 1 diabetes in 2020","volume":"17","author":"Tuomilehto","year":"2020","journal-title":"Pediatr Endocrinol Rev."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2503","DOI":"10.2337\/dc21-0342","article-title":"Incidence of type 1 diabetes may be underestimated in the Chinese population: evidence from 21.7 million people between 2007 and 2017","volume":"44","author":"Liu","year":"2021","journal-title":"Diabetes Care"},{"key":"B5","doi-asserted-by":"publisher","first-page":"j5295","DOI":"10.1136\/bmj.j5295","article-title":"T1D China Study Group. 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