Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia
BackgroundWhile there is increasing evidence for an altered clinical phenotype of Type 1 diabetes in several low-and middle-income countries, little is known about urban-rural differences and how the greater poverty of rural environments may alter the pattern of disease.ObjectiveInvestigation of urb...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Clinical Diabetes and Healthcare |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1298270/full |
| _version_ | 1797341223770390528 |
|---|---|
| author | Shitaye A. Balcha David I. Phillips Elisabeth R. Trimble |
| author_facet | Shitaye A. Balcha David I. Phillips Elisabeth R. Trimble |
| author_sort | Shitaye A. Balcha |
| collection | DOAJ |
| description | BackgroundWhile there is increasing evidence for an altered clinical phenotype of Type 1 diabetes in several low-and middle-income countries, little is known about urban-rural differences and how the greater poverty of rural environments may alter the pattern of disease.ObjectiveInvestigation of urban-rural differences in demographic and anthropometric characteristics of type 1 diabetes in a resource-poor setting.Research design and methodsAnalysis of a unique case register, comprising all patients (rural and urban) presenting with Type 1 diabetes over a 20 yr. period in a poor, geographically defined area in northwest Ethiopia. The records included age, sex, place of residence, together with height and weight at the clinical onset.ResultsA total of 1682 new cases of Type 1 diabetes were registered with a mean age of onset of 31.2 (SD 13.4) yr. The patients were thin with 1/3 presenting with a body mass index (BMI) <17kg/m2. There was a striking male predominance of cases when clinical onset was between 20 and 35 yr., this was more marked in the very poor rural dwellers compared to the urban population. While most patients with Type 1 diabetes presented with low BMIs and reduced height, stunting preferentially affected rural men.ConclusionsThese data have led to the hypothesis that complex interactions among poor socioeconomic conditions in early life affect both pancreatic function and the development of autoimmunity and provide a possible explanation of the unusual phenotype of Type 1 diabetes in this very poor community. |
| first_indexed | 2024-03-08T10:14:45Z |
| format | Article |
| id | doaj.art-8e74047c63c4407c8fe4916c233006c0 |
| institution | Directory Open Access Journal |
| issn | 2673-6616 |
| language | English |
| last_indexed | 2024-03-08T10:14:45Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Clinical Diabetes and Healthcare |
| spelling | doaj.art-8e74047c63c4407c8fe4916c233006c02024-01-29T04:37:05ZengFrontiers Media S.A.Frontiers in Clinical Diabetes and Healthcare2673-66162024-01-01410.3389/fcdhc.2023.12982701298270Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW EthiopiaShitaye A. Balcha0David I. Phillips1Elisabeth R. Trimble2Department of Internal Medicine, Gondar University Hospital, Gondar, EthiopiaMedical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United KingdomCentre for Public Health, Institute of Clinical Science, Queen’s University Belfast, Belfast, United KingdomBackgroundWhile there is increasing evidence for an altered clinical phenotype of Type 1 diabetes in several low-and middle-income countries, little is known about urban-rural differences and how the greater poverty of rural environments may alter the pattern of disease.ObjectiveInvestigation of urban-rural differences in demographic and anthropometric characteristics of type 1 diabetes in a resource-poor setting.Research design and methodsAnalysis of a unique case register, comprising all patients (rural and urban) presenting with Type 1 diabetes over a 20 yr. period in a poor, geographically defined area in northwest Ethiopia. The records included age, sex, place of residence, together with height and weight at the clinical onset.ResultsA total of 1682 new cases of Type 1 diabetes were registered with a mean age of onset of 31.2 (SD 13.4) yr. The patients were thin with 1/3 presenting with a body mass index (BMI) <17kg/m2. There was a striking male predominance of cases when clinical onset was between 20 and 35 yr., this was more marked in the very poor rural dwellers compared to the urban population. While most patients with Type 1 diabetes presented with low BMIs and reduced height, stunting preferentially affected rural men.ConclusionsThese data have led to the hypothesis that complex interactions among poor socioeconomic conditions in early life affect both pancreatic function and the development of autoimmunity and provide a possible explanation of the unusual phenotype of Type 1 diabetes in this very poor community.https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1298270/fulltype 1 diabetesurban ruralanthropometric and demographic differencesresource poor communitiesEthiopia |
| spellingShingle | Shitaye A. Balcha David I. Phillips Elisabeth R. Trimble Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia Frontiers in Clinical Diabetes and Healthcare type 1 diabetes urban rural anthropometric and demographic differences resource poor communities Ethiopia |
| title | Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia |
| title_full | Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia |
| title_fullStr | Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia |
| title_full_unstemmed | Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia |
| title_short | Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia |
| title_sort | type 1 diabetes mellitus in the context of high levels of rural deprivation differences in demographic and anthropometric characteristics between urban and rural cases in nw ethiopia |
| topic | type 1 diabetes urban rural anthropometric and demographic differences resource poor communities Ethiopia |
| url | https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1298270/full |
| work_keys_str_mv | AT shitayeabalcha type1diabetesmellitusinthecontextofhighlevelsofruraldeprivationdifferencesindemographicandanthropometriccharacteristicsbetweenurbanandruralcasesinnwethiopia AT davidiphillips type1diabetesmellitusinthecontextofhighlevelsofruraldeprivationdifferencesindemographicandanthropometriccharacteristicsbetweenurbanandruralcasesinnwethiopia AT elisabethrtrimble type1diabetesmellitusinthecontextofhighlevelsofruraldeprivationdifferencesindemographicandanthropometriccharacteristicsbetweenurbanandruralcasesinnwethiopia |