Incidence, prevalence and mortality of diabetes in children and adolescents aged under 20 years in the Republic of Maldives

AIM: There is little published data on diabetes in youth in the Maldives. This study aimed to determine incidence, prevalence and mortality of diabetes in children and adolescents <20 years. METHODS: Data on all known existing cases in 2009 and all new cases from 2009 to 2018 was collected from the Diabetes Society of the Maldives registry. RESULTS: Thirty-nine subjects <20 years were known to have diabetes at the start of 2009 and 92 new cases were diagnosed from 2009 to 2018. Of the 92 new cases, 76 had type 1 diabetes (T1D), 15 type 2 diabetes (T2D) and one secondary diabetes. Of the 76 new T1D cases, 64 were diagnosed <15 years. Mean age of onset for T1D <20 years was 10 +/- 4.6 years, with 42 (55.3%) female. Ten (13.2%) were diagnosed 0-4 years, 27 (35.5%) 5-9 years, 27 (35.5%) 10-14 years and 12 (15.8%) 15-19 years. Annual T1D mean incidence rates/per 100 000 subjects for <15/<20 years, respectively, increased from 3.6/2.7 in 2009 to 11.0/9.1 in 2018, representing 12.0%/13.0% annualised increases (P = 0.01 for both). T1D prevalence in 2018 for <15 and <20 years was 47.1/100 000 and 52.0/100 000, respectively. No young person with T1D died during this period, with a total of 262 patient-years of follow-up for T1D cases. The child with secondary diabetes died of other causes. CONCLUSION: T1D incidence in Maldives is higher than that reported from other South Asian countries, and an increasing trend was observed. T2D also occurs relatively frequently. A zero mortality rate was observed for children and young adults with T1D and T2D from 2009 to 2018.