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Case Study

BIOMED

Tackling Childhood Diabetes

Pan-European studies into childood diabetes are now well into their second decade, offering hope to millions of children around the world.

 

 

Childhood diabetes is one of the most severe forms of the disease. It cannot be treated by diet, so affected children require daily insulin injections and frequently suffer complications such as eye or kidney problems as they get older. And it is becoming more and more common. The first major pan-European studies into the disease began in 1985, when the Commission established a network linking diabetes specialists across Europe. This was used and expanded by the EURODIAB (Epidemiology and prevention of diabetes) project, which studied the incidence of childhood diabetes across Europe, the complications it causes in later life and its general social impact.
The results, published in The Lancet in the early 1990s, was based on data on 16.8 million children collected in 24 regions across Europe and Israel. They found enormous variation - from 42.9 annual cases per 100,000 in Finland to almost ten times less in northern Greece. Eastern European countries had very low rates - although subsequent studies (below) have since shown an inexplicable rise.

Complex Picture
The next project - EURODIAB ACE (Aetiology of childhood diabetes on an epidemiological basis) - used genetic and immunological methods. About 40 different groups worked together, generating a study population of almost 30 million children.
The results were interesting but painted a complex picture. While some genetic markers were found much more often in children who developed diabetes, the evidence pointed to an interplay between genes and environment, and suggested that this interplay may differ between populations.
The latest phase - EURODIAB TIGER (Type I Genetic Epidemiology Resource) - aims to discover more about the genetic factors and couple the resulting knowledge with information on environmental factors such as lifestyle, diet and viral infections.
Once again, the network will be crucial. It now includes 44 institutions in 28 European nations, and is collecting material from 2,000 patients and their immediate relatives to be analysed for specific genetic and immune markers in conjunction with PARADIGM, a European concerted action which is supplying the central analysis facility.
According to project coordinator Anders Green, "This huge collaborative network is a valuable resource, particularly for Central and Eastern Europe, which will need the support to cope with their growing diabetes problem. It must not be wasted."

       
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