ESPE Abstracts (2016) 86 P-P1-208

Improvement of Diabetic Screening System for School Children Achieved by Close Cooperation with a Local Government of Atsugi City

Maki Saitoa,b, Takanori Motokib, Akira Itoa,b, Takeru Itoa,b, Asako Tajimab, Naoko Tajimac & Ichiro MIyatab


aDepartment of Pediatrics, Atsugi City Hospital, Kanagawa, Japan; bDepartment of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan; cDepartment of Endocrinology, The Jikei University School of Medicine, Tokyo, Japan


Background: In Japan, diabetic screening for school children using urinalysis has been performed to detect diabetes mellitus during childhood throughout the country. However, inadequate follow-up system after urinary screening caused several problems. The rate of participation in workup examination still remains less than 30%. Also, accurate annual incidences of children with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) detected by screening of urine glucose have not been determined.

Objective: Under the cooperation with Atsugi city (population: around 224,000), the present study was performed to achieve full participation of children with positive urine glucose in workup examination, and to clarify accurate annual incidences of children with T1DM and T2DM in Atsugi city.

Subjects and method: Workup examination of diabetes mellitus, including HbA1c and anti-GAD antibody, at our hospital was carried out for children with positive urine glucose for seven years from 2009 through 2015. In addition, we retrospectively analyzed clinical diagnosis and course of them.

Results: Thirty six of 129,125 school children, who were tested by urinalysis, showed positivity of urine glucose. Continuously, all of them could receive secondary workup examination by active support of Atsugi city. Through this screening system, three children were diagnosed as having T2DM. The overall incidence of T2DM was 2.28 per 100,000 per year. On the other hand, two children were diagnosed as having T1DM. The overall incidence of T1DM was 1.58 per 100,000 per year. Furthermore, one child was diagnosed as having insulin receptor abnormality (Rabson–Mendenhall syndrome).

Conclusion: The annual incidences of children with T2DM in Atsugi city was comparable with those in other municipalities (2.65–3.57 per 100,000 per year). However, the annual incidences of children with T1DM was almost three times higher than that in Tokyo (0.51 per 100,000 per year). The reason for this difference is unclear, and therefore further study is required.

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