| 1. |
- Hjern, Anders, et al.
(författare)
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East africans in Sweden have a high risk for type 1 diabetes
- 2012
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Ingår i: Diabetes Care. - Alexandria, USA : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 35:3, s. 597-598
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Tidskriftsartikel (refereegranskat)abstract
- Citing this article BMJ Open October 31, 2013 3:e003418Objective: To investigate the prevalence of type 1 diabetes in children with an origin inSub-Saharan Africa in Sweden.Research design and methods: Nationwide register study based on retrievedprescriptions of insulin during 2009 in children aged 0–18 years. The study population consistedof 35,756 children in families with an origin in Sub-Saharan Africa and 1,666,051 children withnative Swedish parents.Results: The odds ratio (OR) for insulin medication in Swedish-born children in familiesoriginating in East Africa was 1.29 (95% CI 1.02–1.63) compared with offspring of nativeSwedish parents, after adjustment for age and sex, and less common in children who themselveswere born in East Africa: 0.50 (0.34–0.73). Offspring of parents from other parts of Sub-SaharanAfrica had a comparatively low risk for insulin medication.Conclusions: This study indicates that Swedish-born children with an origin in EastAfrica have a high risk of type 1 diabetes.
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| 2. |
- Söderström, Ulf, 1947-, et al.
(författare)
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Being born in Sweden increases the risk for type 1 diabetes : a study of migration of children to Sweden as a natural experiment
- 2012
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Ingår i: Acta Paediatrica. - West Sussex, United Kingdom : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 101:1, s. 73-77
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate whether the age of first exposure to a high-incidence country like Sweden determines the risk of T1DM in children with an origin in a low incidence region of the world.Methods: Register study in a Swedish study population in the age 6–25 years in three categories of residents with an origin in low incidence regions of T1DM (Eastern Europe, East Asia, South Asia and Latin America); 24 252 international adoptees; 47 986 immigrants and 40 971 Swedish-born with two foreign-born parents and a comparison group of 1 770 092 children with Swedish-born parents. Retrieval of a prescription of insulin during 2006 was used as an indicator of T1DM and analysed with logistic regression.Results: The odds ratios (OR) for T1DM were lower than the Swedish majority population for residents with an origin in the four low incidence regions. Being Swedish-born implied a higher risk for T1DM in the four low incidence study groups compared with the internationally adopted with an OR of 1.68 (CI 1.03–2.73).Conclusions: Being born in Sweden increases the risk for T1DM in children with an origin in low incidence countries. This may imply that exposures in utero or very early infancy are important risk factors for T1DM
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| 3. |
- Söderström, Ulf, 1947-
(författare)
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Type 1 diabetes in children with non-Swedish background : epidemiology and clinical outcome
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Sweden holds third place of diabetes incidence in young people after Finland and Sardinia. One fifth of the population is nowadays of foreign descent. We have a substantial number of immigrants from countries where the risk for T1D is considerably lower. Migration as a natural experiment is a concept to assess the risk for diabetes in offspring of immigrant parents and assess the interaction between genetics (genotype) and the impact of environment (phenotype).Aims: To study the risk of incurring diabetes for children of immigrant parents living in Sweden (I) and further study the risk if the child is born in Sweden or not (II); to specifically study and evaluate if children from East Africa have increased risk to develop T1D (III). To investigate if clinical and sociodemographic status at T1D onset differs between immigrant children compared to their Swedish indigenous peers (IV). Finally to study the clinical outcome and the impact of socio-demographic factors at diabetes onset after three years of treatment (V).Methods: All five studies are observational, nationwide and population based, on prospectively collected data. Statistics mainly by logistic and linear regressions.Results: Parental country of origin is a strong determinant for diabetes in the offspring. Children born to immigrant parents seem to keep their low risk compared to their Swedish peers (I). When adding the factor of being born in Sweden, the pattern changed; there was a significantly (p < 0.001) increased risk for T1D if the child was born in Sweden (II). East Africans have a substantial risk for T1D and especially if the children are born in Sweden (III). Immigrant children and adolescents have worse metabolic start at T1D onset compared to their indigenous Swedish peers (IV). After 3 years of treatment, the immigrant children had a sustained higher median HbA1c, compared to their Swedish peers (V).Conclusions: Genotype and influences during fetal life or early infancy have an important impact for the risk of T1D pointing towards epigenetics playing a substantial role. Children with an origin in East Africa have a high risk of incurring T1D. Immigrant children have worse metabolic start at T1D onset, which sustains after three years of treatment
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