RESUMEN
BACKGROUND: Type 1 Diabetes poses a significant public health threat, especially in low-and-middle countries, where resources are limited. The use of geographical information systems in diabetes research has shown the potential to reveal several epidemiological risk factors. AIMS: This scoping review aimed to identify the scope and extent of the current literature and explore its limitations on the geographical mapping of children with type 1 diabetes. METHODS: A scoping review was conducted using five electronic databases and included studies published between the years 2000 and 2023. The search terms included: "Type 1 Diabetes Mellitus", "GIS mapping", "Juvenile Onset Diabetes Mellitus", "Spatial Epidemiology", "Spatial Clustering", "Spatial analysis", and "Geographic information system". Relevant full-text articles that met the inclusion criteria were selected for review. RESULTS: The search identified 17 studies that met the criteria for inclusion in the review. More than half the studies were conducted before 2015 (n=11; 61%). All studies were conducted in High-Income Countries. More than 10 articles studied environmental factors, 3 of them focused on the environment, 6 of them included sociodemographic factors, and 1 study incorporated nutrition (as a variable) in environmental factors. 2 studies focused on the accessibility of health services by pediatric patients. CONCLUSION: Studies on type 1 diabetes highlight the complex relationship between incidence and risk, suggesting comprehensive prevention and treatment. Geographical mapping has potential in low- and middle-income nations, but further research is needed to develop innovative strategies. The importance of geomappping in understanding the risk factors for Type 1 Diabetes is highlighted in this scoping review, which also suggests a possible direction for focused interventions, particularly in settings with low resources.
RESUMEN
Poor foetal growth and subsequent low birth weight are associated with an increased risk for disease later in life. Identifying parental factors that determine foetal growth are important to curbing intergenerational malnutrition, especially among disadvantaged populations in the global south where undernutrition rates are high. The objective of this study was to assess the relationships between parental biometry, intrauterine growth and neonatal outcomes, while factoring in socioeconomic status of historically disadvantaged households in rural India. Using data from the prospective longitudinal cohort, pregnant women from rural Pune, India (n = 134) were assessed between August 2020 and November 2022. Data on socio-demography, ultrasound measurements, parental and foetal anthropometry were collected. Multiple linear regression models were run to predict determinants of foetal intrauterine and neonatal growth (p value<0.05). The dependent variables were ultrasound measurements and neonatal biometry, and independent variables were gestational weight gain, parental and mid-parental height. Mean(±SD) maternal age, maternal height, paternal height and mid-parental height were 22.8±3.7 years, 153.6±5.5cm, 165.9±6.5cm and 159.1±8.7cm, respectively. Pre-pregnancy body mass index and gestational weight gain was 20.5±4.0 kg/m2 and 9.8±3.7kg respectively. Mid-parental height and gestational weight gain were strongly correlated with neonatal growth and foetal intrauterine growth (p<0.05); however, the correlation peaked at 28 weeks of gestation (p<0.05). Gestational weight gain (B = 28.7, p = 0.001) and mid-parental height (B = 14.3, p = 0.001) were identified as strong determinants of foetal-intrauterine growth and neonatal anthropometry at birth. Maternal height was found to influence length of male neonate (B = 0.18, p = 0.001), whereas, paternal height influenced length of the female neonate (B = 0.11, p = 0.01). Parental socio-economic status, biometry and maternal gestational weight gain influence growth of the child starting from the intrauterine period. Our study underlines the need for interventions during pre-pregnancy, as well as during pregnancy, for optimal weight gain and improved foetal and neonatal outcomes.