O-10: Incidence of diabetes in children and adolescents in Dhaka district, Bangladesh: a Population-Based study (2019-2024)
M K Huda, B Zabeen, K Azad, G D Ogle, J Maniam, M A Islam, S JamesAbstract
Introduction
Incidence data on type 1 diabetes (T1D) in South Asian youth are scarce.
Objectives
To estimate the minimum incidence of newly diagnosed T1D in individuals aged <20 years in Dhaka District, Bangladesh; type 2 diabetes (T2D) and other diabetes types were secondary exploratory outcomes.
Methods
A retrospective analysis of newly diagnosed diabetes cases (2019-2024) was conducted using BADAS Paediatric Diabetes Care and Research Center data at BIRDEM Women and Children Hospital. Only Dhaka District residents at diagnosis were included. Diabetes classification followed ISPAD and BADAS guidelines. Population denominators were based on the 2022 Bangladesh Bureau of Statistics census (mid-period estimate). Incidence per 100,000 person-years with 95% CIs was calculated using Poisson approximation, with age- and sex-specific rates, sex incidence rate ratios (IRRs), and clinical comparisons between T1D and T2D.
Results
Among 579 cases, 253 (43.7%) had T1D, giving an incidence of 0.86 (0.76-0.97); age-standardised incidence in <15-year-olds was 1.22 (1.06-1.39). T1D presented earlier than T2D (mean age 9.91±4.30 vs 12.96±3.23 years; p<0.001), with higher HbA1c (12.43±3.01% vs 10.16±2.83%; p<0.001) and more diabetic ketoacidosis (DKA: 15.0% vs 2.8%; p<0.001). T1D incidence was higher in females than males (1.01 vs 0.73; IRR 1.38, 1.08-1.77; p=0.011). Secondary findings included 218 T2D cases (37.7%) with an incidence of 0.74 (0.64-0.84) and strong female predominance (IRR 1.99, 1.51-2.63; p<0.001). Other diabetes types accounted for 108 cases (18.7%) with an incidence of 0.37.
Conclusions
T1D incidence was lower than in many high-income countries and comparable to some South Asian settings. Moderate DKA prevalence indicates delayed recognition in resource limited contexts. Although incidence is underestimated, an estimated 70-80% of new cases present to BIRDEM. Rising adolescent T2D, particularly in females, highlights a growing dual burden requiring urgent public health and diabetes prevention strategies.