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at sea level&#44; with a characteristically Mediterranean warmer and sunny weather&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">We conducted a retrospective study by reviewing the cases of onset of type 1 diabetes in individuals aged less than 19 years in Osona &#40;Barcelona&#41; and Baix Camp &#40;Tarragona&#41; over a period of 13 years &#40;2000&#8211;2012&#41;&#44; obtaining data from the medical records of the paediatric endocrinology units of the two regional public hospitals located at the capital of each region&#58; the Hospital Universitari de Vic and the Hospital Universitari Sant Joan de Reus&#44; which are the referral hospitals for all diabetes onset cases in the area&#46; To calculate incidence rates&#44; we obtained demographic data for the general population from the Institut d&#8217;Estad&#237;stica de Catalunya &#40;Institute of Statistics of Catalonia&#41;&#46; The incidence rate is the number of new cases relative to the overall susceptible population and is expressed per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants &#40;younger than 19 years&#41; per year&#46; We applied a 95&#37; confidence interval to the calculation of incidence rates&#46; We defined T1DM onset and presence of ketoacidosis according to the criteria established by the ISPAD&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> We compared the data by means of the Student&#39;s <span class="elsevierStyleItalic">t</span> test&#44; or with the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test if the size of the compared subsets was small&#46; The level of statistical significance was set at 0&#46;05&#46; The relative risk &#40;RR&#41; was calculated as the ratio of the incidence of T1DM onset and the population under consideration&#46; We expressed metabolic control&#44; assessed by the level of glycated haemoglobin &#40;HbA1c&#41;&#44; as the mean HbA1c level for the last two years&#46; We performed the statistical analysis with the software SPSS version 21 &#40;IBM&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0015" class="elsevierStylePara elsevierViewall">The population under 19 years of age amounted to 53<span class="elsevierStyleHsp" style=""></span>978 inhabitants in 2000&#44; and had increased to 73<span class="elsevierStyleHsp" style=""></span>443 by year 2012&#44; mostly on account of immigration&#46; This increase amounts to 36&#46;6&#37; of the population in this age group&#46; Considering the local population and the immigrant population separately&#44; we observe the following evolution&#58; the native population grew from 51<span class="elsevierStyleHsp" style=""></span>440 to 61<span class="elsevierStyleHsp" style=""></span>202&#44; with an increase of 18&#46;9&#37;&#44; while the immigrant population grew from 2537 to 12<span class="elsevierStyleHsp" style=""></span>240&#44; which amounts to an increase of 482&#37;&#44; that is&#44; it quadrupled &#40;became 4&#46;82 times larger&#41;&#46; The distribution of the child and adolescent population by national origin has changed&#44; as in 2000 95&#46;3&#37; of the population was of Spanish descent and only 4&#46;7&#37; corresponded to immigrants&#44; while in 2012&#44; 83&#46;3&#37; was of Spanish descent&#44; with the proportion of immigrants increasing to 16&#46;7&#37;&#46; As for the countries of origin in the areas under study&#44; most immigrants were Maghrebi &#40;90&#37;&#41;&#44; with a much smaller proportion of Central and South Americans &#40;5&#37;&#41;&#44; Chinese &#40;2&#37;&#41; and Sub-Saharan Africans &#40;2&#37;&#41;&#44; so we narrowed down the analysis of the outcomes to the Maghrebi group alone&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In the thirteen years under study&#44; there were 118 cases of diabetes onset in our two hospitals&#44; which corresponds to a mean 9&#46;1 cases of diabetes onset per year&#46; When it came to age&#44; during this period&#44; in the age 0-to-4 year group 20 cases corresponded to children of Spanish descent and 24 to children of Maghrebi descent&#44; while in the 5-to-18 years age group&#44; 57 occurred in children of Spanish descent and 17 in children of Maghrebi descent&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The incidence rate remained stable in the two regions for the overall population under 19 years of age during the period under study&#44; at 14&#46;4 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 11&#46;8&#8211;31&#46;3&#59; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; whereas narrowing down the group to children aged less than 15 years&#44; this incidence increases to 17&#46;8 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 14&#46;7&#8211;39&#46;2&#41;&#46; The incidence did not vary by sex&#44; and it was 15&#46;1 in males &#40;95&#37; CI&#44; 11&#46;4&#8211;34&#46;0&#41; and 13&#46;4 in females &#40;95&#37; CI&#44; 9&#46;8&#8211;30&#46;5&#41;&#44; a difference that was not statistically significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; However&#44; we did find significant differences between age groups&#44; with an incidence of 18&#46;9 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 6&#46;6&#8211;28&#46;0&#41; in children aged 0&#8211;4 years and of 12&#46;5 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 7&#46;4&#8211;23&#46;7&#41; in the group aged 5 to 18 years &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#59; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; We found the largest differences in the incidence of T1DM in our analysis by the origin of patients&#44; with an incidence of 37&#46;1 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 26&#46;3&#8211;87&#46;5&#41; in children of Maghrebi descent&#44; far higher than the incidence in children of Spanish descent&#44; which was of 11&#46;2 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 7&#46;4&#8211;21&#46;3&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#59; <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#44; with the high incidence of diabetes onset in the under-5 years Maghrebi population compared to the same subset in the local population contributing the most to this difference&#58; 192&#46;0 &#40;95&#37; CI&#44; 115&#46;2&#8211;460&#46;8&#41; versus 8&#46;2 &#40;95&#37; CI&#44; 4&#46;6&#8211;20&#46;0&#41; cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;001&#59; <a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; These differences in incidence by age group and national origin remained when we analysed the two regions separately&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The RR of developing T1DM in our region is 3&#46;1 times higher for the overall Maghrebi population compared to the local population&#44; and 1&#46;5 times higher for children aged fewer than 5 years compared to children aged 5&#8211;18 years&#44; independent of national origin&#46; When we made the analysis by age group&#44; we found that the incidence in the 5-to-18 years group was higher in individuals of Maghrebi versus Spanish descent&#58; 17&#46;8 &#40;95&#37; CI&#44; 9&#46;3&#8211;44&#46;0&#41; versus 10&#46;2 &#40;95&#37; CI&#44; 7&#46;5&#8211;23&#46;1&#41; cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#44; with a RR of 1&#46;7&#46; The difference was substantially larger for the 0-to-4 years age group in the Maghrebi population compared to the corresponding local population&#58; 192&#46;0 &#40;95&#37; CI&#44; 115&#46;2&#8211;460&#46;8&#41; vs&#46; 8&#46;2 &#40;95&#37; CI&#44; 4&#46;6&#8211;20&#46;0&#41; cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; which corresponds to a RR in the Maghrebi under-5 years subset of 23&#46;4 compared to the Spanish subset for the same age&#46; However&#44; we observed a decreasing trend in incidence in the Maghrebi population in the period under study&#44; for while the number of cases per year remained stable&#44; the population of Maghrebi children susceptible to developing the disease also grew&#44; which results in a gradually decreasing trend in incidence over the 13 years under study&#46; Thus&#44; if we divide the period under study in four-year bands&#44; leaving out year 2000&#44; the evolution of the incidence in children of Maghrebi descent &#40;in cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants&#47;year&#41; was 56&#46;5 &#40;95&#37; CI&#44; 34&#46;1&#8211;190&#46;2&#41; in 2001&#8211;2004&#44; 25&#46;4 &#40;95&#37; CI&#44; 9&#46;4&#8211;64&#46;8&#41; in 2005&#8211;2008&#44; and 29&#46;9 &#40;95&#37; CI&#44; 15&#46;4&#8211;78&#46;2&#41; in 2009&#8211;2012&#46; Meanwhile&#44; the incidence remained stable in children of Spanish descent&#46; The decrease in the incidence of diabetes onset in the immigrant population is explained mostly by a decrease in the incidence in the under-5 years population&#44; although the incidence also decreased in the group aged 5-to-18 years &#40;<a class="elsevierStyleCrossRefs" href="#fig0020">Figs&#46; 4 and 5</a>&#41;&#46; We found that in 2000&#44; the first year in the study&#44; there were extreme incidence values in the Maghrebi population &#40;118&#46;2 cases per 10<span class="elsevierStyleSup">5</span> inhabitants&#47;year&#59; 95&#37; CI&#44; 0&#46;0&#8211;370&#46;2&#41;&#44; mostly on account of the under-5 years &#40;636&#46;9 cases per 10<span class="elsevierStyleSup">5</span> inhabitants&#47;year&#59; 95&#37; CI&#44; 0&#46;0&#8211;2153&#46;8&#41; and due to the small size of this subpopulation&#44; which is why we omitted this year in the charts &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figs&#46; 2&#8211;5</a>&#41;&#44; starting the graphical representation at year 2001 to smooth the incidence trendlines&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">We analysed other factors&#44; such as the presence of ketoacidosis at onset&#46; Out of the total cases&#44; 45&#46;8&#37; presented with ketoacidosis at onset compared to 54&#46;2&#37; that did not&#46; We found statistically significant differences in the presence of ketoacidosis by age group&#44; as it was found in 48&#46;1&#37; of the under-5 years group and in 51&#46;9&#37; of de 5-to-18 years group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;025&#41;&#46; However&#44; we did not find differences based on origin&#44; with ketoacidosis present in 48&#46;7&#37; of the Maghrebi descent group and 44&#46;3&#37; of the Spanish descent group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Metabolic control did not vary by age or origin of the individuals included in the study&#46; The mean level of HbA1c in the last two years was similar in the 0-to-4 years and the 5-to-18 years age groups &#40;8&#46;8&#37; and 8&#46;6&#37;&#44; respectively&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;036&#41;&#46; The Spanish and Maghrebi origin groups also had similar HbA1c levels &#40;8&#46;5&#37; and 9&#46;0&#37;&#44; respectively&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;066&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">If we refer to the world-wide incidence study of Karvonen et al&#46; in which Spain is represented by data from the Catalonia register&#44; with an incidence classified as high of 12&#46;6 &#40;expressed in cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#41;&#44; our age 5-to-18 years subset would have a similar incidence at 12&#46;5&#59; however&#44; the incidence in Spanish natives would be lower&#44; of 11&#46;1&#46; The incidence in the under-5 years subset&#44; of 18&#46;9&#44; and in the Maghrebi descend subset&#44; of 37&#46;1&#44; would both exceed previously reported rates&#44; especially in the Maghrebi descent group&#44; which would be at the level of very high-incidence countries such as Sweden or Finland &#40;27&#46;5 and 36&#46;5 cases per 10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>inhabitants&#47;year&#44; respectively&#41; and in the Maghrebi subset of under-5 years&#44; with an incidence that has not yet been reported in any country &#40;192&#46;0 cases per 10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>inhabitants&#47;year&#41;&#46; Although we found this very high incidence in Maghrebi immigrants residing in Spain and we have not found any published registers for the incidence of diabetes in Morocco&#44; we did find records for neighbouring countries where the incidence is intermediate&#44; such as Algeria and Tunisia&#44; with an incidence of 5&#46;7 and 4&#46;9&#8211;8&#46;8 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#44; respectively&#46; Although we cannot know how reliable the registers showing these low incidence rates may be&#44; the high incidence found in individuals of Maghrebi descent residing in Spain is still striking&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">If we consider the percent distribution of the overall population aged less than 19 years&#44; with 17&#37; of Maghrebi descent and 83&#37; of Spanish descent&#44; we would expect a similar distribution in the population with T1DB if national origin were not a risk factor for the disease&#59; however&#44; we found that the percentage of diabetes onset cases was nearly double in the Maghrebi population &#40;33&#37;&#41; while there was a relative reduction in the Spanish population &#40;67&#37;&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">We ought to underscore the very high incidence found in the under-5 years age group in the Maghrebi population compared to the Spanish population &#40;192&#46;0 vs&#46; 8&#46;2 cases per 10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>inhabitants&#47;year&#41;&#46; While the absolute frequency of diabetes onset cases in children aged less than 5 years during the period under study was 24 for a susceptible population in the denominator of 12<span class="elsevierStyleHsp" style=""></span>498&#44; for the purposes of analysis it would be convenient to have a base population of 100<span class="elsevierStyleHsp" style=""></span>000 children under five years to obtain a more accurate incidence&#44; which would allow better comparisons with homologous age groups from other geographical areas&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Current recorded incidence rates in Spain vary widely by autonomous community&#44; ranging from 11&#46;5 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year in Asturias to 27&#46;6 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year in Castilla-La Mancha&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> When it came to our study&#44; the incidence rate for the overall sample was in the high range at 14&#46;4 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#59; however&#44; we found a strikingly high incidence the Maghrebi population of 37&#46;1 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#44; corresponding to a RR 3&#46;1 times higher than the RR in children of Spanish descent and up to 23&#46;4 times higher in Maghrebi children aged less than 5 years&#46; The potential impact of immigration in the pathophysiology of diabetes development is generating considerable interest and studies on the subject are starting to be published&#44; especially in countries with a high incidence such as Sweden&#46; Hussen et al&#46; analysed the incidence of T1DM in individuals born in Sweden based on parental origin&#44; and found that individuals born to two native Swedes had an increased RR of having T1DM compared to individuals with one foreign-born parent&#44; in who the risk decreased by 15&#8211;30&#37; with an even greater risk reduction if both parents had been born abroad&#46; These differences were confirmed for immigrants from Asia&#44; South and North America and Western and Eastern Europe&#46; Conversely&#44; the RR of developing T1DM was 20&#8211;40&#37; higher in immigrants of African descent&#44; especially those from North or East Africa&#44; a region that includes Morocco&#44; which is therefore consistent with our results&#46; This increased risk has also been observed in African immigrants residing in Sweden&#46; These findings suggest that genetic predisposition interacts with environmental factors in the new country of residence&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> an observation that had already been made by Hjern and S&#246;derstr&#246;m&#44; who found an increased incidence in individuals of East African descent born in Sweden compared to a reduced incidence in individuals born in Africa that migrated at a later point&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> S&#246;derstr&#246;m et al&#46; also found an increased incidence in individuals born in Sweden to parents from low-incidence countries compared to adopted individuals&#44; which suggests that some of the environmental factors at play in high-incidence countries may act during intrauterine development or in very early infancy&#44; triggering the pathophysiological process that leads to T1DM&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> The Hussen group recently added that the risk of developing T1DM in children born to immigrant mothers also increases with the amount of time the mother has been in Sweden&#44; that is&#44; the longer the time of residence in Sweden&#44; the greater the risk of developing T1DM&#44; which also points at the importance of environmental factors or lifestyle changes as determinants in the aetiology of T1DM&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> Gillespie et al&#46; have previously reported that while the global incidence of T1DM is increasing&#44; the frequency of high-risk HLA DR3-DQ2&#47;DR4-DQ8 haplotypes in patients with a T1DM diagnosis has been decreasing&#44; which increases the relevance of the hypothesis that environmental factors play a greater role in the increase in global incidence than genetic factors&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Although studies conducted in the past have reported a greater prevalence of ketoacidosis at the time of diagnosis in the under-5 years age group&#44; our analysis did not lead to the same results&#44; as the prevalence of ketoacidosis was slightly lower than in the 5-to-18 years age group&#59; and unlike what has been described for the United States&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> our analysis of prevalence by origin found a similar proportion in Spanish natives than in the immigrant population&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Consistent with the data reported by Okrainec et al&#46;&#44; who found no difference in the incidence of diabetes complications between locals and immigrants&#44; we did not find differences in the level of metabolic control based on national origin&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Finally&#44; we conclude that the children and adolescent population of Maghrebi descent that resides in our area has a risk of developing T1DM that is three times as high as that of the Spanish population of the same age&#44; and up to 23 times higher for children aged less than 5 years&#44; which opens a field of investigation on the risk factors that may be affecting this population in the destination countries&#44; with the greatest impact on the under-5 years age group&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicts of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">It has been postulated that migration could act as a modifying factor in the incidence of type 1 diabetes mellitus &#40;T1DM&#41;&#44; so the aim of this study is to determine if there are differences in the incidence of T1DM by origin&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of cases of T1DM onset in the population younger than 19 years old in Osona and Baix Camp between 2000 and 2012&#44; using the medical histories of endocrinology units of the health centres and demographics from Catalonia Statistical Institute as sources&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The child population in Osona and Baix Camp increased by 36&#46;6&#37;&#44; with 18&#46;9&#37; in the local population&#44; and 482&#37; in the immigrant population&#44; and most of this increase &#40;90&#37;&#41; in the Maghreb immigrant group&#46; A total of 118 diabetics onset were found&#44; 66&#46;9&#37; in the local population&#44; 32&#46;2&#37; Maghrebi population&#44; and 0&#46;9&#37; in children from other countries&#44; with a total incidence rate of 14&#46;4 cases per 100&#44;000 population&#47;year &#40;c&#47;10<span class="elsevierStyleSup">5</span>p-y&#41;&#46; The incidence is higher in the Maghrebi population compared to the local population&#44; 37&#46;1 vs 11&#46;2 c&#47;10<span class="elsevierStyleSup">5</span>p-y &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; and in children under 5 years compared to the 5&#8211;18 years group&#44; 18&#46;9 vs 12&#46;5 c&#47;10<span class="elsevierStyleSup">5</span>p-y &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#44; with no differences between sexes &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; The relative risk is 3&#46;1 for the Maghrebi population&#44; and 1&#46;5 for children under 5 years&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The total incidence of T1DM remains stable&#44; but is higher in the Maghrebi than in the local population&#44; and in children under 5 years compared to 5&#8211;18 years group&#46; These results open a study field of which risk factors could be affecting this immigrant population in their destination countries&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se ha postulado que la migraci&#243;n podr&#237;a actuar como factor modificador de la incidencia de diabetes tipo 1 &#40;DM1&#41;&#44; por lo que el objetivo de este estudio es determinar si existen diferencias en la incidencia de DM1 seg&#250;n el origen&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de los casos de debut diab&#233;tico tipo 1 en menores de 19 a&#241;os en las comarcas de Osona y Baix Camp entre los a&#241;os 2000 y 2012&#44; utilizando la historia cl&#237;nica de las unidades de endocrinolog&#237;a y los datos demogr&#225;ficos del Institut d¿Estad&#237;stica de Catalunya&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La poblaci&#243;n infantil en Osona y el Baix Camp aument&#243; un 36&#44;6&#37;&#44; un 18&#44;9&#37; los aut&#243;ctonos y un 482&#37; los inmigrantes&#44; a expensas mayoritariamente del colectivo magreb&#237; &#40;90&#37;&#41;&#46; Han acontecido 118 debuts diab&#233;ticos&#44; 66&#44;9&#37; en nativos&#44; 32&#44;2&#37; en magreb&#237;es y 0&#44;9&#37; en ni&#241;os de otros pa&#237;ses&#44; con una tasa de incidencia total de 14&#44;4 casos&#47;100&#46;000 habitantes&#47;a&#241;o &#40;c&#47;10<span class="elsevierStyleSup">5</span> h-a&#41;&#46; La incidencia es mayor en magreb&#237;es respecto a aut&#243;ctonos&#44; 37&#44;1 vs&#46; 11&#44;2 c&#47;10<span class="elsevierStyleSup">5</span> h-a &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y en menores de 5 a&#241;os respecto a los de 5 a 18 a&#241;os&#44; 18&#44;9 vs&#46; 12&#44;5 &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; sin observar diferencias entre sexos &#40;p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El riesgo relativo es 3&#44;1 para magreb&#237;es y 1&#44;5 para menores de 5 a&#241;os&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La incidencia total de DM1 se mantiene estable&#44; pero es mayor en magreb&#237;es que en nativos y en menores de 5 a&#241;os respecto a los de 5&#8211;18 a&#241;os&#46; Estos resultados abren un campo de estudio sobre los factores de riesgo que podr&#237;an estar incidiendo sobre esta poblaci&#243;n en los pa&#237;ses de destino&#46;</p></span>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Evolution of the incidence rate of type 1 diabetes mellitus in the native and the immigrant populations of Osona and Baix Camp between 2001 and 2012&#46; The incidence rate is expressed as number of cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#46;</p>"
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Introduction to ISPAD Clinical Practice Consensus Guidelines 2014 Compendium"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Acerini"
                            1 => "M&#46;E&#46; Craig"
                            2 => "C&#46; de Beaufort"
                            3 => "D&#46;M&#46; Maahs"
                            4 => "R&#46; Hanas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/pedi.12194"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Diabetes"
                        "fecha" => "2014"
                        "volumen" => "15"
                        "numero" => "Suppl&#46; 20"
                        "paginaInicial" => "1"
                        "paginaFinal" => "3"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25187438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of childhood type 1 diabetes worlwide"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Karvonen"
                            1 => "M&#46; Vilkkajander"
                            2 => "E&#46; Moltchanova"
                            3 => "I&#46; Libman"
                            4 => "R&#46; LaPorte"
                            5 => "J&#46; Tuomilehto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes Care"
                        "fecha" => "2000"
                        "volumen" => "23"
                        "paginaInicial" => "1516"
                        "paginaFinal" => "1526"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11023146"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "189&#46;e1&#8211;189&#46;e12"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiolog&#237;a de la diabetes mellitus tipo 1 en menores de 15 a&#241;os en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Conde"
                            1 => "M&#46; Rodr&#237;guez"
                            2 => "G&#46; Bueno"
                            3 => "J&#46;P&#46; L&#243;pez"
                            4 => "B&#46; Gonz&#225;lez"
                            5 => "M&#46;P&#46; Rodrigo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2014"
                        "volumen" => "81"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The trends and the risk of type 1 diabetes over the past 40 years&#58; an analysis by birth cohorts and by parental migration background in Sweden"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;I&#46; Hussen"
                            1 => "M&#46; Persson"
                            2 => "T&#46; Moradi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmjopen-2013-003418"
                      "Revista" => array:4 [
                        "tituloSerie" => "BMJ Open"
                        "fecha" => "2013"
                        "volumen" => "3"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24176795"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "East africans in Sweden have a high risk for type 1 diabetes"
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                            2 => "J&#46; &#197;man"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2337/dc11-1536"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes Care"
                        "fecha" => "2012"
                        "volumen" => "35"
                        "paginaInicial" => "597"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22301119"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Being born in Sweden increases the risk for type 1 diabetes&#8212;a study of migration of children to Sweden as a natural experiment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
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                            2 => "A&#46; Hjern"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1651-2227.2011.02410.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2012"
                        "volumen" => "101"
                        "paginaInicial" => "73"
                        "paginaFinal" => "77"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21767306"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The risk of type 1 diabetes among offspring of immigrant mothers in relation to the duration of residency in Sweden"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;I&#46; Hussen"
                            1 => "T&#46; Moradi"
                            2 => "M&#46; Persson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2337/dc14-2348"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes Care"
                        "fecha" => "2015"
                        "volumen" => "38"
                        "paginaInicial" => "934"
                        "paginaFinal" => "936"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25678102"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The rising tide of childhood type 1 diabetes &#8211; what is the elusive environmental trigger"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Rewers"
                            1 => "P&#46; Zimmet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(04)17368-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2004"
                        "volumen" => "364"
                        "paginaInicial" => "1645"
                        "paginaFinal" => "1647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15530607"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The rising incidence of childhood type 1 diabetes and reduced contribution of high-risk HLA haplotypes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;M&#46; Gillespie"
                            1 => "S&#46;C&#46; Bain"
                            2 => "A&#46;H&#46; Barnett"
                            3 => "P&#46;J&#46; Bingley"
                            4 => "M&#46;R&#46; Christie"
                            5 => "G&#46;V&#46; Gill"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(04)17357-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2004"
                        "volumen" => "364"
                        "paginaInicial" => "1699"
                        "paginaFinal" => "1700"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15530631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in the prevalence of ketoacidosis at diabetes diagnosis&#58; the SEARCH for Diabetes in Youth Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "A&#46; Rewers"
                            2 => "J&#46;M&#46; Stafford"
                            3 => "D&#46;A&#46; Standiford"
                            4 => "J&#46;M&#46; Lawrence"
                            5 => "S&#46; Saydah"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2013-2795"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2014"
                        "volumen" => "133"
                        "paginaInicial" => "e938"
                        "paginaFinal" => "e945"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24685959"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0110"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of language barriers on complications and mortality among immigrants with diabetes&#58; a population-based cohort study"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:4 [
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                            1 => "G&#46;L&#46; Booth"
                            2 => "S&#46; Hollands"
                            3 => "C&#46;M&#46; Bell"
                          ]
                        ]
                      ]
                    ]
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                        "tituloSerie" => "Diabetes Care"
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                        "paginaInicial" => "189"
                        "paginaFinal" => "196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25028526"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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                ]
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High incidence of type 1 diabetes in the immigrant population of Osona and Baix Camp
Alta incidencia de diabetes tipo 1 en población magrebí de Osona y Baix Camp
Meritxell Torrabías-Rodasa,
Corresponding author
mtorrabias@chv.cat

Corresponding author.
, Albert Feliu-Rovirab, Ines Porcar-Cardonab, Jacint Altimiras-Rosetc
a Endocrinología Pediátrica, Pediatría, Hospital Universitari de Vic, Vic, Barcelona, Spain
b Endocrinología Pediátrica, Pediatría, Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain
c Unidad Clínico-epidemiológica, Hospital Universitari de Vic, Vic, Barcelona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In the past two decades&#44; we have experienced large migratory movements in Europe as well as in Spain&#44; leading to an increase in the immigrant population that has been associated with changes in health care&#46; Most of the immigrant population comes from regions with a lower incidence of type 1 diabetes mellitus &#40;T1DM&#41; than that of Spain&#44; so we were interested in analysing the changes in the incidence of this disease in the period corresponding to this spike in immigration&#44; and specifically in two regions in Catalonia&#58; Osona&#44; located inland in a plain 499<span class="elsevierStyleHsp" style=""></span>m above sea level with continental weather and persistent fog during the winter&#44; and the Baix Camp&#44; at sea level&#44; with a characteristically Mediterranean warmer and sunny weather&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">We conducted a retrospective study by reviewing the cases of onset of type 1 diabetes in individuals aged less than 19 years in Osona &#40;Barcelona&#41; and Baix Camp &#40;Tarragona&#41; over a period of 13 years &#40;2000&#8211;2012&#41;&#44; obtaining data from the medical records of the paediatric endocrinology units of the two regional public hospitals located at the capital of each region&#58; the Hospital Universitari de Vic and the Hospital Universitari Sant Joan de Reus&#44; which are the referral hospitals for all diabetes onset cases in the area&#46; To calculate incidence rates&#44; we obtained demographic data for the general population from the Institut d&#8217;Estad&#237;stica de Catalunya &#40;Institute of Statistics of Catalonia&#41;&#46; The incidence rate is the number of new cases relative to the overall susceptible population and is expressed per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants &#40;younger than 19 years&#41; per year&#46; We applied a 95&#37; confidence interval to the calculation of incidence rates&#46; We defined T1DM onset and presence of ketoacidosis according to the criteria established by the ISPAD&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> We compared the data by means of the Student&#39;s <span class="elsevierStyleItalic">t</span> test&#44; or with the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test if the size of the compared subsets was small&#46; The level of statistical significance was set at 0&#46;05&#46; The relative risk &#40;RR&#41; was calculated as the ratio of the incidence of T1DM onset and the population under consideration&#46; We expressed metabolic control&#44; assessed by the level of glycated haemoglobin &#40;HbA1c&#41;&#44; as the mean HbA1c level for the last two years&#46; We performed the statistical analysis with the software SPSS version 21 &#40;IBM&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0015" class="elsevierStylePara elsevierViewall">The population under 19 years of age amounted to 53<span class="elsevierStyleHsp" style=""></span>978 inhabitants in 2000&#44; and had increased to 73<span class="elsevierStyleHsp" style=""></span>443 by year 2012&#44; mostly on account of immigration&#46; This increase amounts to 36&#46;6&#37; of the population in this age group&#46; Considering the local population and the immigrant population separately&#44; we observe the following evolution&#58; the native population grew from 51<span class="elsevierStyleHsp" style=""></span>440 to 61<span class="elsevierStyleHsp" style=""></span>202&#44; with an increase of 18&#46;9&#37;&#44; while the immigrant population grew from 2537 to 12<span class="elsevierStyleHsp" style=""></span>240&#44; which amounts to an increase of 482&#37;&#44; that is&#44; it quadrupled &#40;became 4&#46;82 times larger&#41;&#46; The distribution of the child and adolescent population by national origin has changed&#44; as in 2000 95&#46;3&#37; of the population was of Spanish descent and only 4&#46;7&#37; corresponded to immigrants&#44; while in 2012&#44; 83&#46;3&#37; was of Spanish descent&#44; with the proportion of immigrants increasing to 16&#46;7&#37;&#46; As for the countries of origin in the areas under study&#44; most immigrants were Maghrebi &#40;90&#37;&#41;&#44; with a much smaller proportion of Central and South Americans &#40;5&#37;&#41;&#44; Chinese &#40;2&#37;&#41; and Sub-Saharan Africans &#40;2&#37;&#41;&#44; so we narrowed down the analysis of the outcomes to the Maghrebi group alone&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In the thirteen years under study&#44; there were 118 cases of diabetes onset in our two hospitals&#44; which corresponds to a mean 9&#46;1 cases of diabetes onset per year&#46; When it came to age&#44; during this period&#44; in the age 0-to-4 year group 20 cases corresponded to children of Spanish descent and 24 to children of Maghrebi descent&#44; while in the 5-to-18 years age group&#44; 57 occurred in children of Spanish descent and 17 in children of Maghrebi descent&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The incidence rate remained stable in the two regions for the overall population under 19 years of age during the period under study&#44; at 14&#46;4 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 11&#46;8&#8211;31&#46;3&#59; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; whereas narrowing down the group to children aged less than 15 years&#44; this incidence increases to 17&#46;8 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 14&#46;7&#8211;39&#46;2&#41;&#46; The incidence did not vary by sex&#44; and it was 15&#46;1 in males &#40;95&#37; CI&#44; 11&#46;4&#8211;34&#46;0&#41; and 13&#46;4 in females &#40;95&#37; CI&#44; 9&#46;8&#8211;30&#46;5&#41;&#44; a difference that was not statistically significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; However&#44; we did find significant differences between age groups&#44; with an incidence of 18&#46;9 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 6&#46;6&#8211;28&#46;0&#41; in children aged 0&#8211;4 years and of 12&#46;5 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 7&#46;4&#8211;23&#46;7&#41; in the group aged 5 to 18 years &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#59; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; We found the largest differences in the incidence of T1DM in our analysis by the origin of patients&#44; with an incidence of 37&#46;1 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 26&#46;3&#8211;87&#46;5&#41; in children of Maghrebi descent&#44; far higher than the incidence in children of Spanish descent&#44; which was of 11&#46;2 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;95&#37; CI&#44; 7&#46;4&#8211;21&#46;3&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#59; <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#44; with the high incidence of diabetes onset in the under-5 years Maghrebi population compared to the same subset in the local population contributing the most to this difference&#58; 192&#46;0 &#40;95&#37; CI&#44; 115&#46;2&#8211;460&#46;8&#41; versus 8&#46;2 &#40;95&#37; CI&#44; 4&#46;6&#8211;20&#46;0&#41; cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;001&#59; <a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; These differences in incidence by age group and national origin remained when we analysed the two regions separately&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The RR of developing T1DM in our region is 3&#46;1 times higher for the overall Maghrebi population compared to the local population&#44; and 1&#46;5 times higher for children aged fewer than 5 years compared to children aged 5&#8211;18 years&#44; independent of national origin&#46; When we made the analysis by age group&#44; we found that the incidence in the 5-to-18 years group was higher in individuals of Maghrebi versus Spanish descent&#58; 17&#46;8 &#40;95&#37; CI&#44; 9&#46;3&#8211;44&#46;0&#41; versus 10&#46;2 &#40;95&#37; CI&#44; 7&#46;5&#8211;23&#46;1&#41; cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#44; with a RR of 1&#46;7&#46; The difference was substantially larger for the 0-to-4 years age group in the Maghrebi population compared to the corresponding local population&#58; 192&#46;0 &#40;95&#37; CI&#44; 115&#46;2&#8211;460&#46;8&#41; vs&#46; 8&#46;2 &#40;95&#37; CI&#44; 4&#46;6&#8211;20&#46;0&#41; cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; which corresponds to a RR in the Maghrebi under-5 years subset of 23&#46;4 compared to the Spanish subset for the same age&#46; However&#44; we observed a decreasing trend in incidence in the Maghrebi population in the period under study&#44; for while the number of cases per year remained stable&#44; the population of Maghrebi children susceptible to developing the disease also grew&#44; which results in a gradually decreasing trend in incidence over the 13 years under study&#46; Thus&#44; if we divide the period under study in four-year bands&#44; leaving out year 2000&#44; the evolution of the incidence in children of Maghrebi descent &#40;in cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants&#47;year&#41; was 56&#46;5 &#40;95&#37; CI&#44; 34&#46;1&#8211;190&#46;2&#41; in 2001&#8211;2004&#44; 25&#46;4 &#40;95&#37; CI&#44; 9&#46;4&#8211;64&#46;8&#41; in 2005&#8211;2008&#44; and 29&#46;9 &#40;95&#37; CI&#44; 15&#46;4&#8211;78&#46;2&#41; in 2009&#8211;2012&#46; Meanwhile&#44; the incidence remained stable in children of Spanish descent&#46; The decrease in the incidence of diabetes onset in the immigrant population is explained mostly by a decrease in the incidence in the under-5 years population&#44; although the incidence also decreased in the group aged 5-to-18 years &#40;<a class="elsevierStyleCrossRefs" href="#fig0020">Figs&#46; 4 and 5</a>&#41;&#46; We found that in 2000&#44; the first year in the study&#44; there were extreme incidence values in the Maghrebi population &#40;118&#46;2 cases per 10<span class="elsevierStyleSup">5</span> inhabitants&#47;year&#59; 95&#37; CI&#44; 0&#46;0&#8211;370&#46;2&#41;&#44; mostly on account of the under-5 years &#40;636&#46;9 cases per 10<span class="elsevierStyleSup">5</span> inhabitants&#47;year&#59; 95&#37; CI&#44; 0&#46;0&#8211;2153&#46;8&#41; and due to the small size of this subpopulation&#44; which is why we omitted this year in the charts &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figs&#46; 2&#8211;5</a>&#41;&#44; starting the graphical representation at year 2001 to smooth the incidence trendlines&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">We analysed other factors&#44; such as the presence of ketoacidosis at onset&#46; Out of the total cases&#44; 45&#46;8&#37; presented with ketoacidosis at onset compared to 54&#46;2&#37; that did not&#46; We found statistically significant differences in the presence of ketoacidosis by age group&#44; as it was found in 48&#46;1&#37; of the under-5 years group and in 51&#46;9&#37; of de 5-to-18 years group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;025&#41;&#46; However&#44; we did not find differences based on origin&#44; with ketoacidosis present in 48&#46;7&#37; of the Maghrebi descent group and 44&#46;3&#37; of the Spanish descent group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Metabolic control did not vary by age or origin of the individuals included in the study&#46; The mean level of HbA1c in the last two years was similar in the 0-to-4 years and the 5-to-18 years age groups &#40;8&#46;8&#37; and 8&#46;6&#37;&#44; respectively&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;036&#41;&#46; The Spanish and Maghrebi origin groups also had similar HbA1c levels &#40;8&#46;5&#37; and 9&#46;0&#37;&#44; respectively&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;066&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">If we refer to the world-wide incidence study of Karvonen et al&#46; in which Spain is represented by data from the Catalonia register&#44; with an incidence classified as high of 12&#46;6 &#40;expressed in cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#41;&#44; our age 5-to-18 years subset would have a similar incidence at 12&#46;5&#59; however&#44; the incidence in Spanish natives would be lower&#44; of 11&#46;1&#46; The incidence in the under-5 years subset&#44; of 18&#46;9&#44; and in the Maghrebi descend subset&#44; of 37&#46;1&#44; would both exceed previously reported rates&#44; especially in the Maghrebi descent group&#44; which would be at the level of very high-incidence countries such as Sweden or Finland &#40;27&#46;5 and 36&#46;5 cases per 10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>inhabitants&#47;year&#44; respectively&#41; and in the Maghrebi subset of under-5 years&#44; with an incidence that has not yet been reported in any country &#40;192&#46;0 cases per 10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>inhabitants&#47;year&#41;&#46; Although we found this very high incidence in Maghrebi immigrants residing in Spain and we have not found any published registers for the incidence of diabetes in Morocco&#44; we did find records for neighbouring countries where the incidence is intermediate&#44; such as Algeria and Tunisia&#44; with an incidence of 5&#46;7 and 4&#46;9&#8211;8&#46;8 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#44; respectively&#46; Although we cannot know how reliable the registers showing these low incidence rates may be&#44; the high incidence found in individuals of Maghrebi descent residing in Spain is still striking&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">If we consider the percent distribution of the overall population aged less than 19 years&#44; with 17&#37; of Maghrebi descent and 83&#37; of Spanish descent&#44; we would expect a similar distribution in the population with T1DB if national origin were not a risk factor for the disease&#59; however&#44; we found that the percentage of diabetes onset cases was nearly double in the Maghrebi population &#40;33&#37;&#41; while there was a relative reduction in the Spanish population &#40;67&#37;&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">We ought to underscore the very high incidence found in the under-5 years age group in the Maghrebi population compared to the Spanish population &#40;192&#46;0 vs&#46; 8&#46;2 cases per 10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>inhabitants&#47;year&#41;&#46; While the absolute frequency of diabetes onset cases in children aged less than 5 years during the period under study was 24 for a susceptible population in the denominator of 12<span class="elsevierStyleHsp" style=""></span>498&#44; for the purposes of analysis it would be convenient to have a base population of 100<span class="elsevierStyleHsp" style=""></span>000 children under five years to obtain a more accurate incidence&#44; which would allow better comparisons with homologous age groups from other geographical areas&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Current recorded incidence rates in Spain vary widely by autonomous community&#44; ranging from 11&#46;5 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year in Asturias to 27&#46;6 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year in Castilla-La Mancha&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> When it came to our study&#44; the incidence rate for the overall sample was in the high range at 14&#46;4 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#59; however&#44; we found a strikingly high incidence the Maghrebi population of 37&#46;1 cases per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants per year&#44; corresponding to a RR 3&#46;1 times higher than the RR in children of Spanish descent and up to 23&#46;4 times higher in Maghrebi children aged less than 5 years&#46; The potential impact of immigration in the pathophysiology of diabetes development is generating considerable interest and studies on the subject are starting to be published&#44; especially in countries with a high incidence such as Sweden&#46; Hussen et al&#46; analysed the incidence of T1DM in individuals born in Sweden based on parental origin&#44; and found that individuals born to two native Swedes had an increased RR of having T1DM compared to individuals with one foreign-born parent&#44; in who the risk decreased by 15&#8211;30&#37; with an even greater risk reduction if both parents had been born abroad&#46; These differences were confirmed for immigrants from Asia&#44; South and North America and Western and Eastern Europe&#46; Conversely&#44; the RR of developing T1DM was 20&#8211;40&#37; higher in immigrants of African descent&#44; especially those from North or East Africa&#44; a region that includes Morocco&#44; which is therefore consistent with our results&#46; This increased risk has also been observed in African immigrants residing in Sweden&#46; These findings suggest that genetic predisposition interacts with environmental factors in the new country of residence&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> an observation that had already been made by Hjern and S&#246;derstr&#246;m&#44; who found an increased incidence in individuals of East African descent born in Sweden compared to a reduced incidence in individuals born in Africa that migrated at a later point&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> S&#246;derstr&#246;m et al&#46; also found an increased incidence in individuals born in Sweden to parents from low-incidence countries compared to adopted individuals&#44; which suggests that some of the environmental factors at play in high-incidence countries may act during intrauterine development or in very early infancy&#44; triggering the pathophysiological process that leads to T1DM&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> The Hussen group recently added that the risk of developing T1DM in children born to immigrant mothers also increases with the amount of time the mother has been in Sweden&#44; that is&#44; the longer the time of residence in Sweden&#44; the greater the risk of developing T1DM&#44; which also points at the importance of environmental factors or lifestyle changes as determinants in the aetiology of T1DM&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> Gillespie et al&#46; have previously reported that while the global incidence of T1DM is increasing&#44; the frequency of high-risk HLA DR3-DQ2&#47;DR4-DQ8 haplotypes in patients with a T1DM diagnosis has been decreasing&#44; which increases the relevance of the hypothesis that environmental factors play a greater role in the increase in global incidence than genetic factors&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Although studies conducted in the past have reported a greater prevalence of ketoacidosis at the time of diagnosis in the under-5 years age group&#44; our analysis did not lead to the same results&#44; as the prevalence of ketoacidosis was slightly lower than in the 5-to-18 years age group&#59; and unlike what has been described for the United States&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> our analysis of prevalence by origin found a similar proportion in Spanish natives than in the immigrant population&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Consistent with the data reported by Okrainec et al&#46;&#44; who found no difference in the incidence of diabetes complications between locals and immigrants&#44; we did not find differences in the level of metabolic control based on national origin&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Finally&#44; we conclude that the children and adolescent population of Maghrebi descent that resides in our area has a risk of developing T1DM that is three times as high as that of the Spanish population of the same age&#44; and up to 23 times higher for children aged less than 5 years&#44; which opens a field of investigation on the risk factors that may be affecting this population in the destination countries&#44; with the greatest impact on the under-5 years age group&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicts of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">It has been postulated that migration could act as a modifying factor in the incidence of type 1 diabetes mellitus &#40;T1DM&#41;&#44; so the aim of this study is to determine if there are differences in the incidence of T1DM by origin&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of cases of T1DM onset in the population younger than 19 years old in Osona and Baix Camp between 2000 and 2012&#44; using the medical histories of endocrinology units of the health centres and demographics from Catalonia Statistical Institute as sources&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The child population in Osona and Baix Camp increased by 36&#46;6&#37;&#44; with 18&#46;9&#37; in the local population&#44; and 482&#37; in the immigrant population&#44; and most of this increase &#40;90&#37;&#41; in the Maghreb immigrant group&#46; A total of 118 diabetics onset were found&#44; 66&#46;9&#37; in the local population&#44; 32&#46;2&#37; Maghrebi population&#44; and 0&#46;9&#37; in children from other countries&#44; with a total incidence rate of 14&#46;4 cases per 100&#44;000 population&#47;year &#40;c&#47;10<span class="elsevierStyleSup">5</span>p-y&#41;&#46; The incidence is higher in the Maghrebi population compared to the local population&#44; 37&#46;1 vs 11&#46;2 c&#47;10<span class="elsevierStyleSup">5</span>p-y &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; and in children under 5 years compared to the 5&#8211;18 years group&#44; 18&#46;9 vs 12&#46;5 c&#47;10<span class="elsevierStyleSup">5</span>p-y &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#44; with no differences between sexes &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; The relative risk is 3&#46;1 for the Maghrebi population&#44; and 1&#46;5 for children under 5 years&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The total incidence of T1DM remains stable&#44; but is higher in the Maghrebi than in the local population&#44; and in children under 5 years compared to 5&#8211;18 years group&#46; These results open a study field of which risk factors could be affecting this immigrant population in their destination countries&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se ha postulado que la migraci&#243;n podr&#237;a actuar como factor modificador de la incidencia de diabetes tipo 1 &#40;DM1&#41;&#44; por lo que el objetivo de este estudio es determinar si existen diferencias en la incidencia de DM1 seg&#250;n el origen&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de los casos de debut diab&#233;tico tipo 1 en menores de 19 a&#241;os en las comarcas de Osona y Baix Camp entre los a&#241;os 2000 y 2012&#44; utilizando la historia cl&#237;nica de las unidades de endocrinolog&#237;a y los datos demogr&#225;ficos del Institut d¿Estad&#237;stica de Catalunya&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La poblaci&#243;n infantil en Osona y el Baix Camp aument&#243; un 36&#44;6&#37;&#44; un 18&#44;9&#37; los aut&#243;ctonos y un 482&#37; los inmigrantes&#44; a expensas mayoritariamente del colectivo magreb&#237; &#40;90&#37;&#41;&#46; Han acontecido 118 debuts diab&#233;ticos&#44; 66&#44;9&#37; en nativos&#44; 32&#44;2&#37; en magreb&#237;es y 0&#44;9&#37; en ni&#241;os de otros pa&#237;ses&#44; con una tasa de incidencia total de 14&#44;4 casos&#47;100&#46;000 habitantes&#47;a&#241;o &#40;c&#47;10<span class="elsevierStyleSup">5</span> h-a&#41;&#46; La incidencia es mayor en magreb&#237;es respecto a aut&#243;ctonos&#44; 37&#44;1 vs&#46; 11&#44;2 c&#47;10<span class="elsevierStyleSup">5</span> h-a &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y en menores de 5 a&#241;os respecto a los de 5 a 18 a&#241;os&#44; 18&#44;9 vs&#46; 12&#44;5 &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; sin observar diferencias entre sexos &#40;p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El riesgo relativo es 3&#44;1 para magreb&#237;es y 1&#44;5 para menores de 5 a&#241;os&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La incidencia total de DM1 se mantiene estable&#44; pero es mayor en magreb&#237;es que en nativos y en menores de 5 a&#241;os respecto a los de 5&#8211;18 a&#241;os&#46; Estos resultados abren un campo de estudio sobre los factores de riesgo que podr&#237;an estar incidiendo sobre esta poblaci&#243;n en los pa&#237;ses de destino&#46;</p></span>"
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        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Introduction to ISPAD Clinical Practice Consensus Guidelines 2014 Compendium"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Acerini"
                            1 => "M&#46;E&#46; Craig"
                            2 => "C&#46; de Beaufort"
                            3 => "D&#46;M&#46; Maahs"
                            4 => "R&#46; Hanas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/pedi.12194"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Diabetes"
                        "fecha" => "2014"
                        "volumen" => "15"
                        "numero" => "Suppl&#46; 20"
                        "paginaInicial" => "1"
                        "paginaFinal" => "3"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25187438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of childhood type 1 diabetes worlwide"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Karvonen"
                            1 => "M&#46; Vilkkajander"
                            2 => "E&#46; Moltchanova"
                            3 => "I&#46; Libman"
                            4 => "R&#46; LaPorte"
                            5 => "J&#46; Tuomilehto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes Care"
                        "fecha" => "2000"
                        "volumen" => "23"
                        "paginaInicial" => "1516"
                        "paginaFinal" => "1526"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11023146"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "189&#46;e1&#8211;189&#46;e12"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiolog&#237;a de la diabetes mellitus tipo 1 en menores de 15 a&#241;os en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Conde"
                            1 => "M&#46; Rodr&#237;guez"
                            2 => "G&#46; Bueno"
                            3 => "J&#46;P&#46; L&#243;pez"
                            4 => "B&#46; Gonz&#225;lez"
                            5 => "M&#46;P&#46; Rodrigo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2014"
                        "volumen" => "81"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The trends and the risk of type 1 diabetes over the past 40 years&#58; an analysis by birth cohorts and by parental migration background in Sweden"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
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                            2 => "T&#46; Moradi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmjopen-2013-003418"
                      "Revista" => array:4 [
                        "tituloSerie" => "BMJ Open"
                        "fecha" => "2013"
                        "volumen" => "3"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24176795"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            4 => array:3 [
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                0 => array:2 [
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                      "titulo" => "East africans in Sweden have a high risk for type 1 diabetes"
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                      ]
                    ]
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                  "host" => array:1 [
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                      "doi" => "10.2337/dc11-1536"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes Care"
                        "fecha" => "2012"
                        "volumen" => "35"
                        "paginaInicial" => "597"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22301119"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Being born in Sweden increases the risk for type 1 diabetes&#8212;a study of migration of children to Sweden as a natural experiment"
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                            2 => "A&#46; Hjern"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1651-2227.2011.02410.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2012"
                        "volumen" => "101"
                        "paginaInicial" => "73"
                        "paginaFinal" => "77"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21767306"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
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              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The risk of type 1 diabetes among offspring of immigrant mothers in relation to the duration of residency in Sweden"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
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                            1 => "T&#46; Moradi"
                            2 => "M&#46; Persson"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2337/dc14-2348"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes Care"
                        "fecha" => "2015"
                        "volumen" => "38"
                        "paginaInicial" => "934"
                        "paginaFinal" => "936"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25678102"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0095"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The rising tide of childhood type 1 diabetes &#8211; what is the elusive environmental trigger"
                      "autores" => array:1 [
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                          "etal" => false
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                      "doi" => "10.1016/S0140-6736(04)17368-6"
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                        "tituloSerie" => "Lancet"
                        "fecha" => "2004"
                        "volumen" => "364"
                        "paginaInicial" => "1645"
                        "paginaFinal" => "1647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15530607"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                ]
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              "identificador" => "bib0100"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The rising incidence of childhood type 1 diabetes and reduced contribution of high-risk HLA haplotypes"
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                          "autores" => array:6 [
                            0 => "K&#46;M&#46; Gillespie"
                            1 => "S&#46;C&#46; Bain"
                            2 => "A&#46;H&#46; Barnett"
                            3 => "P&#46;J&#46; Bingley"
                            4 => "M&#46;R&#46; Christie"
                            5 => "G&#46;V&#46; Gill"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
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                      "doi" => "10.1016/S0140-6736(04)17357-1"
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                        "fecha" => "2004"
                        "volumen" => "364"
                        "paginaInicial" => "1699"
                        "paginaFinal" => "1700"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15530631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Trends in the prevalence of ketoacidosis at diabetes diagnosis&#58; the SEARCH for Diabetes in Youth Study"
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                            3 => "D&#46;A&#46; Standiford"
                            4 => "J&#46;M&#46; Lawrence"
                            5 => "S&#46; Saydah"
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                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2014"
                        "volumen" => "133"
                        "paginaInicial" => "e938"
                        "paginaFinal" => "e945"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24685959"
                            "web" => "Medline"
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                      ]
                    ]
                  ]
                ]
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                    0 => array:2 [
                      "titulo" => "Impact of language barriers on complications and mortality among immigrants with diabetes&#58; a population-based cohort study"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25028526"
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Article information
ISSN: 23412879
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 3 8 11
2024 October 52 30 82
2024 September 46 21 67
2024 August 68 53 121
2024 July 38 26 64
2024 June 65 29 94
2024 May 51 33 84
2024 April 50 34 84
2024 March 58 28 86
2024 February 54 31 85
2024 January 49 25 74
2023 December 46 19 65
2023 November 50 22 72
2023 October 39 22 61
2023 September 29 21 50
2023 August 29 16 45
2023 July 35 27 62
2023 June 32 23 55
2023 May 43 29 72
2023 April 28 14 42
2023 March 36 25 61
2023 February 34 17 51
2023 January 20 26 46
2022 December 47 29 76
2022 November 53 33 86
2022 October 44 49 93
2022 September 40 36 76
2022 August 43 62 105
2022 July 29 26 55
2022 June 31 48 79
2022 May 39 44 83
2022 April 29 35 64
2022 March 68 59 127
2022 February 43 31 74
2022 January 68 58 126
2021 December 50 45 95
2021 November 47 48 95
2021 October 69 112 181
2021 September 55 40 95
2021 August 42 57 99
2021 July 38 33 71
2021 June 55 34 89
2021 May 53 45 98
2021 April 86 74 160
2021 March 58 63 121
2021 February 40 29 69
2021 January 34 19 53
2020 December 34 27 61
2020 November 33 14 47
2020 October 24 17 41
2020 September 23 18 41
2020 August 16 24 40
2020 July 97 35 132
2020 June 24 19 43
2020 May 26 15 41
2020 April 45 14 59
2020 March 35 20 55
2020 February 33 13 46
2020 January 35 15 50
2019 December 55 16 71
2019 November 21 15 36
2019 October 31 14 45
2019 September 39 18 57
2019 August 54 13 67
2019 July 32 22 54
2019 June 23 25 48
2019 May 54 14 68
2019 April 122 25 147
2019 March 34 12 46
2019 February 40 14 54
2019 January 29 20 49
2018 December 34 27 61
2018 November 81 21 102
2018 October 137 18 155
2018 September 52 5 57
2018 August 1 0 1
2018 June 4 0 4
2018 May 6 0 6
2018 April 49 0 49
2018 March 32 0 32
2018 February 20 0 20
2018 January 12 0 12
2017 December 17 0 17
2017 November 12 0 12
2017 October 11 0 11
2017 September 13 0 13
2017 August 19 0 19
2017 July 16 1 17
2017 June 34 8 42
2017 May 32 11 43
2017 April 164 136 300
2017 March 8 13 21
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Anales de Pediatría (English Edition)
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?