Altering Trends in the Epidemiology of Type 1 Diabetes Mellitus in Children and Adolescents

Diabetes mellitus is a group of metabolic diseases characterised by chronic hyperglycemia resulting from defects in insulin secretion and/or insulin action, or both [1]. The history of diabetes dates back to 1550 BC as the polyuric states were described in an Egyptian papyrus, where treatment was given with a four day decoction of bones, wheat, grain, grit and earth. The term diabetes was coined by Aretaeus of Cappadocia in the 2nd century AD for conditions causing increased urine output. The sweet taste of diabetic urine was noted in the 5th century AD by Indian physicians and in 1776, Matthew Dobson confirmed that diabetic serum and urine contained sugar. The revolution in the history of Diabetes was the discovery of insulin by Banting, Best and colleagues in 1922 (http://wwunix.oit.umass.edu /~abhu000/diabetes/index.html). Type 1 diabetes mellitus (T1DM) is one of the most common endocrine metabolic disorders in children and adolescence worldwide with serious acute and chronic complications. It has been proven that T1DM represents the ending result of an autoimmune destruction of the pancreatic islet beta cells in genetically susceptible individuals exposed to certain but still unclear environmental factors. The precise cause of T1DM is not known. However, multiple genetic and environmental risk factors seem to play an important role in the genesis of the disease. The genetic background is complex and difficult to be explained by the involvement of HLA gene region alone. On the other hand viral and nutritional factors changing continuously from country to country, may contribute to the etiology of T1DM. There is no doubt that monitoring temporal trends and incidence of T1DM contribute to the international effort to determine the exact pathogenesis of the disease and it is of critical public health importance. All these temporal trends in the incidence of T1DM have provided significant clues for understanding the disease, most likely reflecting environmental changes more than genetic changes and detecting the factors that implicated in this increase. In this chapter we review the changing trends in the epidemiology of T1DM and we present data on the rising incidence of T1DM in Greek Cypriot population.