Childhood diabetes identified in mass urine screening program in Taiwan, 1993-1999

To describe the gender differences in cases and characteristics of diabetes mellitus (DM) that can be identified from a mass urine screen program for school children in Taiwan.

Screening for the childhood asymptomatic proteinuria and glucosuria began in 1992 for school children. Students were instructed to collect mid-stream samples of the first morning urine for glucosuria and proteinuria tests using urine strip devices. Students with positive results for glucose and/or protein and/or occult blood in the first examination received a second urine test. The third screening test was performed for urine and fasting blood sample for 11-item examinations if the second test was positive. The 1997 criteria of American Diabetes Association were used for defining DM.

Approximately 2,615,000-2,932,000 students received the preliminary screening each semester. The overall average rates of newly identified diabetes from 1993 to 1999 were 8.3 per 100,000 among boys, and 12.0 per 100,000 among girls. The average rate of new cases increased significantly from sixth grade for boys and fourth grade for girls, with peak rates of 14.7 per 100,000 in eighth grade for boys and 19.0 per 100,000 in sixth grade for girls. Similar prevalence trends by sex and grade were observed, higher in girls than in boys.

This mass screening data suggest that childhood diabetes of all types in Taiwan is elevated in the age of puberty and higher in girls than in boys.