Antonio García‐Hermoso

Aims The aim of this study was to determine the global incidence of type 1 diabetes mellitus (T1DM) in children and adolescents under 20 years of age from 2000 to 2022. Materials and Methods Two reviewers searched three electronic databases (PubMed, Web of Science, and CINAHL) for studies published between January 2000 and November 2022. Pooled estimates of T1DM incidence with a 95% confidence interval (CI) per 100,000 person‐years were calculated by country/region, sex, age, and COVID‐19 pandemic period (pre‐COVID‐19 and pandemic). Results The study included 126 studies from 55 countries and 18 regions. The incidence rate (IR) of T1DM from 2000 to 2022 was 14.07 (95%CI, 12.15–16.29) per 100,000 person‐years. Finland and high‐income North America had the highest IR, with 56.81 (95%CI, 55.91–57.73) and 28.77 (95%CI, 26.59–31.13) per 100,000 person‐years, respectively. The IR was 13.37 (95%CI, 10.60–16.88) per 100,000 person‐years in boys and 13.87 (95%CI, 11.51–16.70) per 100,000 person‐years in girls. There were statistically significant differences among different age ranges: 0–4 versus 5–9 and 10–14 years old ( p < 0.001); 5–9 versus 15–19 ( p < 0.001) and 10–14 versus 15–19 years old ( p = 0.003). Finally, during the pandemic period (2020–2022), the IR was 24.84 (95%CI, 17.16–35.96) per 100,000 person‐years, which was higher but not significant compared with the prepandemic period (2017–2019) of 13.56 (95%CI, 7.49–24.56) per 100,000 person‐years ( p = 0.090). Conclusions The IR of T1DM in children and adolescents under 20 years of age is substantial, especially during the pandemic period, although it varies across regions. More reliable data from additional countries are needed to determine the worldwide incidence of T1DM.

Background Physical inactivity, excessive sedentary time, and lack of sleep time have been independently associated with lower health‐related physical fitness. However, little is known about the combined association between 24‐h movement guidelines (i.e., physical activity, recreational screen time, and sleep duration) and components of physical fitness. Objective The main aim was to examine the likelihood of having high/very high levels on different components of physical fitness based on meeting with 24‐h movement guidelines. Methods In this cross‐sectional study, 1276 Spanish youths (13.07 ± 0.86; 55.88% boys), aged 11–16 years, completed self‐reported questionnaires on physical activity, recreational screen time, and sleep duration. Physical fitness components were assessed by 20‐m shuttle‐run test, standing long jump test, handgrip strength test, and 4 × 10‐m shuttle‐run test. Meeting 24‐h movement guidelines was defined as: 9–11 h/day (children aged 5–13) or 8–10 h/day (adolescents aged 14–17) of sleep, ≤2 h/day of recreational screen time and at least 60 min/day of moderate‐to‐vigorous physical activity. The probability of having a high/very high score for each physical fitness components (i.e., ≥60th centile according to the normative cut‐off points for European adolescents) in relation to adherence to 24‐h movement guidelines was analyzed using a series of binary logistic regressions. Results Participants who met the three 24‐h movement guidelines were more likely to have high/very high for cardiorespiratory fitness (OR = 3.31; 95% CI: 1.79, 6.14; p < 0.001), standing long jump (OR = 1.91; 95% CI: 1.06, 3.45; p = 0.031), muscular fitness (OR = 2.05; 95% CI: 1.09, 3.86; p = 0.048) and physical fitness (OR = 1.99; 95% CI: 1.08, 3.66; p = 0.012), but not for handgrip strength (OR = 1.15; 95% CI: 0.64, 2.01; p = 0.636) and speed/agility (OR = 1.65; 95% CI: 0.92, 2.96; p = 0.093), compared to those who did not meet all three recommendations. Conclusion Since meeting the three 24‐h movement guidelines increased the likelihood of having higher levels in most physical fitness components, it seems necessary to promote these movement behaviors early in life, as they could serve as a gateway for improving health‐related fitness in future generations.