**3.1 T1D territorial dissimilarity and clusterization**

The data on adult T1D prevalence in 24 Ukrainian regions (Table 1) indicated territorial dissimilarity: chi-square = 648.30, degree of freedom, *k* =23 (*p*< 0.001).

Further multiple comparisons using the modified Marascuilo procedure (Marascuilo, 1966) allowed conducting a pairwise assessment of each region. This assessment enabled clustering of the regions according to T1D prevalence. The flagged regions that did not statistically differ from the minimal level according to prevalence were considered as a cluster. This procedure was repeated for the remaining regions as well. The following regional clusters were distinguished according to the T1D prevalence:

Minimal prevalence cluster = AR Crimea, Ivano-Frankivska, Mykolaivska, Odeska, Chernivetska, and Luganska regions.

Intermediate prevalence cluster = Vinnitska, Volynska, Dnipropetrovska, Donetska, Zhytomyrska, Zakarpatska, Kirovogradska, Lvivska, Rivnenska, Kievska, Sumska, Ternopilska, Poltavska, Khersonska, and Cherkaska regions.

Maximal prevalence cluster = Zaporizka, Khmelnytska, and Chernigivska regions.

Cases of T1D in each regional cluster were unified and the prevalence was calculated for the actual clusters. The T1D prevalence was found to be 6 (5–6), −7 (6–7), and −9 (8–9) per 10,000 adults, for the minimal, intermediate, and maximal prevalence clusters respectively. A comparison of the differences between these groups indicated a high level of confidence (χ<sup>2</sup> = 214.4; *p*< 0.001), as shown in figure 1.

Prevalence of Type 1 Diabetes Correlates with Daily Insulin Dose, Adverse

among males.

emerge above and below the boxes)

**3.3 T1D insulin doses assessment** 

Number of T1D

Man

Note: Р (man/women) < 0.001

Outcomes and with Autoimmune Process Against Glutamic Acid Decarboxylase in Adults 67

the 25 regions with the fraction of T1D males revealed a certain variation according to the territorial attribute (chi-square = 67.70, the degrees of freedom, k =24; p <0.001). However, multiple comparisons failed to reveal any distinctions according to the fraction of T1D males between the specific regions. Furthermore, it must be noted that there was no increase in the

It is possible that an increase in the male fraction in this population reflects the epidemiological peculiarities of this disease, which have not yet been described by the identified (as well as the unknown) factors that could lead to the increase in the mortality

Note: given Means ± SE (the dot within the box and height of boxes respectively), 95% CI (lines that

Fig. 1. Prevalence of Type 1 Diabetes Mellitus Diagnosed in Patients Under the Age of 30 in Territorial Clusters of Ukrainian Regions (per 10 000 adults, 95% CI) (Khalangot et al., 2009 d)

The data analysis of the 23,633 T1D patients (Table 2) from the register, who were classified according to insulin dose, age, and disease duration, indicated that women have a higher average age and disease duration, but lower daily insulin dose, when compared with men.

(12364) 32.48 (11.60) 14.11 (10.47) 52.03 (18.56) Women (11269) 33.38 (12.43) 15.69 (10.99) 49.50 (17.98) Total (23633) 32.91 (12,01) 14.86 (10.75) 50.83 (18.33)

Table 2. Average Age, Disease Duration, and Daily Insulin Dose of Type 1 Diabetes Mellitus

Patients in Ukraine According to the Diabetes Register data (Khalangot et al., 2009 d)

yrs(SD)

Mean insulin dose, U/day (SD)

patients (n) Mean age, yrs(SD) Mean diabetes duration,

female fraction among T1D adults, which is common in the general population.


Table 1. Prevalence of Type 1 Diabetes Mellitus in Adults Diagnosed Before the Age of 30 in Ukrainian Regions (Khalangot et al., 2009d)

#### **3.2 T1D gender assessment**

The fraction of males among the 26,796 adults diagnosed before the age of 30 years corresponded to 52.95%, and varied from 49.2% in Luganska to 60.1% in Chernivetska regions. In the majority (23 out of 25) of the regions, this fraction was >50%. Comparison of the 25 regions with the fraction of T1D males revealed a certain variation according to the territorial attribute (chi-square = 67.70, the degrees of freedom, k =24; p <0.001). However, multiple comparisons failed to reveal any distinctions according to the fraction of T1D males between the specific regions. Furthermore, it must be noted that there was no increase in the female fraction among T1D adults, which is common in the general population.

It is possible that an increase in the male fraction in this population reflects the epidemiological peculiarities of this disease, which have not yet been described by the identified (as well as the unknown) factors that could lead to the increase in the mortality among males.

Note: given Means ± SE (the dot within the box and height of boxes respectively), 95% CI (lines that emerge above and below the boxes)

Fig. 1. Prevalence of Type 1 Diabetes Mellitus Diagnosed in Patients Under the Age of 30 in Territorial Clusters of Ukrainian Regions (per 10 000 adults, 95% CI) (Khalangot et al., 2009 d)
