PEDIATRIC INSULIN-DEPENDENT DIABETES MELLITUS (IDDM): EMERGING EPICENTER -PREVALENCE, DETERMINANTS AND PREVENTION IN INDIA: A SYSTEMATIC REVIEW

Abstract

Methods: A systematic review was conducted with PRISMA guidelines. PubMed, Scopus, Embase and Google Scholar databases were systematically searched up to June 2026. Studies on the incidence, prevalence, clinical determinants or preventative policy for T1DM among Indian population aged < 18 years were given preference. Quality appraisal was performed with ROBINS-I and RoB 2 quality framework, with the aim of generating metrics for graphical mapping with the visualization engine `robvis`. Objectives: To review and collate data regarding prevalence, socio-behavioural and genetic risk factors, and clinical preventive measures for IDDM in children aged <18 years in India. Results: Total of 28 studies were found that met the strict inclusion criteria. The Indian Council of Medical Research (ICMR) Youth Onset Diabetes Registry (YDR) data and the regional cohorts demonstrated extensive geographical variations. There were wide variations in the prevalence ranging from 3.2 per 100,000 in Chennai to 31.9 per 100,000 in urban Karnal (Haryana). The following factors were found to be important: high-risk human leukocyte antigen (HLA) alleles (DQB1*0201/0302), socio-economic factors which make it difficult to access care, and high initial presentation of diabetic ketoacidosis (DKA). The focus is on tertiary prevention strategies, such as structural health programmes and decentralised access to insulin. Conclusion:  IDDM in children in India is moving towards a public health crisis. To respond to this transition, the national clinical register needs to be expanded, early diagnostic screening should be optimized in rural primary health care service, and therapeutic supply chains need to be standardized.