metricas
covid
Buscar en
Endocrinología, Diabetes y Nutrición (English ed.)
Toda la web
Inicio Endocrinología, Diabetes y Nutrición (English ed.) Type 1 diabetes mellitus prevalence and care in children under 15 years old in A...
Journal Information

Statistics

Follow this link to access the full text of the article

Original article
Type 1 diabetes mellitus prevalence and care in children under 15 years old in Asturias
Prevalencia y datos asistenciales de la diabetes mellitus tipo 1 en menores de 15 años en Asturias
Sofía Osorio Álvarez
Corresponding author
fifioa@hotmail.com

Corresponding author.
, María del Rosario Riestra Rodríguez, Raquel López Sánchez, Fernando Alonso Pérez, Enrique Oltra Rodríguez
Facultad de Enfermería de Gijón, Cabueñes, Gijón, Asturias, Spain
Read
1783
Times
was read the article
393
Total PDF
1390
Total HTML
Share statistics
 array:24 [
  "pii" => "S253001801930037X"
  "issn" => "25300180"
  "doi" => "10.1016/j.endien.2018.08.005"
  "estado" => "S300"
  "fechaPublicacion" => "2019-03-01"
  "aid" => "847"
  "copyright" => "SEEN and SED"
  "copyrightAnyo" => "2018"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Endocrinol Diabetes Nutr. 2019;66:188-94"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 63
    "formatos" => array:2 [
      "HTML" => 41
      "PDF" => 22
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S2530016418302131"
      "issn" => "25300164"
      "doi" => "10.1016/j.endinu.2018.08.008"
      "estado" => "S300"
      "fechaPublicacion" => "2019-03-01"
      "aid" => "847"
      "copyright" => "SEEN y SED"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Endocrinol Diabetes Nutr. 2019;66:188-94"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 227
        "formatos" => array:2 [
          "HTML" => 153
          "PDF" => 74
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>"
        "titulo" => "Prevalencia y datos asistenciales de la diabetes mellitus tipo 1 en menores de 15 a&#241;os en Asturias"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "188"
            "paginaFinal" => "194"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Type 1 diabetes mellitus prevalence and care in children under 15 years old in Asturias"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1372
                "Ancho" => 2509
                "Tamanyo" => 314638
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Mapa sanitario de Asturias con poblaci&#243;n total y menores de 14 a&#241;os</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Fuente&#58; Servicio de Salud del Principado de Asturias&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Sof&#237;a Osorio &#193;lvarez, Mar&#237;a del Rosario Riestra Rodr&#237;guez, Raquel L&#243;pez S&#225;nchez, Fernando Alonso P&#233;rez, Enrique Oltra Rodr&#237;guez"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "Sof&#237;a"
                "apellidos" => "Osorio &#193;lvarez"
              ]
              1 => array:2 [
                "nombre" => "Mar&#237;a del Rosario"
                "apellidos" => "Riestra Rodr&#237;guez"
              ]
              2 => array:2 [
                "nombre" => "Raquel"
                "apellidos" => "L&#243;pez S&#225;nchez"
              ]
              3 => array:2 [
                "nombre" => "Fernando"
                "apellidos" => "Alonso P&#233;rez"
              ]
              4 => array:2 [
                "nombre" => "Enrique"
                "apellidos" => "Oltra Rodr&#237;guez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S253001801930037X"
          "doi" => "10.1016/j.endien.2018.08.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S253001801930037X?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016418302131?idApp=UINPBA00004N"
      "url" => "/25300164/0000006600000003/v1_201903120615/S2530016418302131/v1_201903120615/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2530018019300393"
    "issn" => "25300180"
    "doi" => "10.1016/j.endien.2018.08.006"
    "estado" => "S300"
    "fechaPublicacion" => "2019-03-01"
    "aid" => "845"
    "copyright" => "SEEN and SED"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Endocrinol Diabetes Nutr. 2019;66:195-201"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 65
      "formatos" => array:2 [
        "HTML" => 42
        "PDF" => 23
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Serum levels of intact parathyroid hormone on the first day after total thyroidectomy as predictor of permanent hypoparathyroidism"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "195"
          "paginaFinal" => "201"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Uso del valor de la hormona paratiroidea intacta en el primer d&#237;a postoperatorio tras tiroidectom&#237;a total como predictor de hipoparatiroidismo permanente"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1235
              "Ancho" => 2167
              "Tamanyo" => 129344
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow chart of patients included in the study&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pablo Calvo Espino, Jos&#233; &#193;ngel Rivera Bautista, Mariano Art&#233;s Caselles, Javier Serrano Gonz&#225;lez, Arturo Garc&#237;a Pav&#237;a, Miguel Juan Garc&#237;a-Oria, Fernando Caravaca-Font&#225;n, Jos&#233; Luis Lucena de la Poza, V&#237;ctor S&#225;nchez Turri&#243;n"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Pablo"
              "apellidos" => "Calvo Espino"
            ]
            1 => array:2 [
              "nombre" => "Jos&#233; &#193;ngel"
              "apellidos" => "Rivera Bautista"
            ]
            2 => array:2 [
              "nombre" => "Mariano"
              "apellidos" => "Art&#233;s Caselles"
            ]
            3 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Serrano Gonz&#225;lez"
            ]
            4 => array:2 [
              "nombre" => "Arturo"
              "apellidos" => "Garc&#237;a Pav&#237;a"
            ]
            5 => array:2 [
              "nombre" => "Miguel Juan"
              "apellidos" => "Garc&#237;a-Oria"
            ]
            6 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Caravaca-Font&#225;n"
            ]
            7 => array:2 [
              "nombre" => "Jos&#233; Luis"
              "apellidos" => "Lucena de la Poza"
            ]
            8 => array:2 [
              "nombre" => "V&#237;ctor"
              "apellidos" => "S&#225;nchez Turri&#243;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S2530016418302118"
        "doi" => "10.1016/j.endinu.2018.08.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016418302118?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018019300393?idApp=UINPBA00004N"
    "url" => "/25300180/0000006600000003/v1_201904190633/S2530018019300393/v1_201904190633/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2530018019300368"
    "issn" => "25300180"
    "doi" => "10.1016/j.endien.2019.03.001"
    "estado" => "S300"
    "fechaPublicacion" => "2019-03-01"
    "aid" => "853"
    "copyright" => "SEEN and SED"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Endocrinol Diabetes Nutr. 2019;66:181-7"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 55
      "formatos" => array:2 [
        "HTML" => 41
        "PDF" => 14
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "25-Hydroxyvitamin D serum levels in rheumatic female patients in southeast Spain&#58; The paradigm of daily optimal sunshine levels and inadequate vitamin D status"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "181"
          "paginaFinal" => "187"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Concentraciones s&#233;ricas de 25-hidroxivitamina D en mujeres reum&#225;ticas del sureste de Espa&#241;a&#58; el paradigma de los niveles diarios &#243;ptimos de luz solar y la insuficiencia de vitamina D"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1221
              "Ancho" => 1583
              "Tamanyo" => 87018
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Patients mean 25OHD serum levels according to different seasons&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Claudia Alejandra Pereda, Mar&#237;a Betina Nishishinya, Emilio J&#46;A&#46; Roldan"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Claudia Alejandra"
              "apellidos" => "Pereda"
            ]
            1 => array:2 [
              "nombre" => "Mar&#237;a Betina"
              "apellidos" => "Nishishinya"
            ]
            2 => array:2 [
              "nombre" => "Emilio J&#46;A&#46;"
              "apellidos" => "Roldan"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018019300368?idApp=UINPBA00004N"
    "url" => "/25300180/0000006600000003/v1_201904190633/S2530018019300368/v1_201904190633/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Type 1 diabetes mellitus prevalence and care in children under 15 years old in Asturias"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "188"
        "paginaFinal" => "194"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Sof&#237;a Osorio &#193;lvarez, Mar&#237;a del Rosario Riestra Rodr&#237;guez, Raquel L&#243;pez S&#225;nchez, Fernando Alonso P&#233;rez, Enrique Oltra Rodr&#237;guez"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "Sof&#237;a"
            "apellidos" => "Osorio &#193;lvarez"
            "email" => array:1 [
              0 => "fifioa&#64;hotmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Mar&#237;a del Rosario"
            "apellidos" => "Riestra Rodr&#237;guez"
          ]
          2 => array:2 [
            "nombre" => "Raquel"
            "apellidos" => "L&#243;pez S&#225;nchez"
          ]
          3 => array:2 [
            "nombre" => "Fernando"
            "apellidos" => "Alonso P&#233;rez"
          ]
          4 => array:2 [
            "nombre" => "Enrique"
            "apellidos" => "Oltra Rodr&#237;guez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Facultad de Enfermer&#237;a de Gij&#243;n&#44; Cabue&#241;es&#44; Gij&#243;n&#44; Asturias&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Prevalencia y datos asistenciales de la diabetes mellitus tipo 1 en menores de 15 a&#241;os en Asturias"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1376
            "Ancho" => 2511
            "Tamanyo" => 311744
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Healthcare map of Asturias with total population and population under 14 years of age&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">According to the International Diabetes Federation&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> 586&#44;000 children and adolescents under 15 years of age have type 1 diabetes mellitus &#40;DM1&#41; worldwide&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">According to the different published studies&#44; the prevalence of DM1 in Spain ranges from 0&#46;95 cases&#47;1000 inhabitants in the recruitment population of Hospital de M&#233;rida<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> to 1&#46;7 cases&#47;1000 in Andalusia&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In Asturias&#44; two epidemiological studies have been carried out on DM1 in patients under 15 years of age&#46; The first of these studies was conducted in 1998 and reported an incidence of 11&#46;5 cases&#47;100&#44;000 inhabitants&#47;year in the period 1991&#8211;1995&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> The second study in turn reported an adjusted incidence of 15&#46;6 cases&#47;100&#44;000 inhabitants&#47;year in the period 2002&#8211;2011&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> However&#44; until the present study&#44; the prevalence of DM1 in children under 15 years of age in the region of Asturias was not known&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Studies have been carried out in Europe for years not only to determine the epidemiological characteristics of DM1&#44; but also to analyze the resources and particularities of the different healthcare centers that care for these patients&#46; Such aspects appear to have an influence upon patient evolution&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">6&#44;7</span></a> A recent study in the Spanish Autonomous Community of Andalusia has described the situation there with regard to human resources&#44; healthcare data and the use of advanced technology&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The purpose of the present study was to determine the prevalence of type 1 diabetes mellitus in children under 15 years of age in the region of Asturias&#44; as well as the healthcare resources and data being used&#46; These aspects are essential for detecting the needs of patients and their families&#44; and for the better planning of socio-sanitary care&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">A descriptive&#44; cross-sectional observational study was made of the population born between 1 January 2000 and 31 December 2014&#44; diagnosed with DM1 as established on 31 December 2014&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The inclusion criteria were&#58; patients under 15 years of age with DM1 and living in Asturias on 31 December 2014&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The Asturias Healthcare Map &#40;Mapa Sanitario de Asturias&#41; is territorially structured into 8 administrative areas&#46; In 2014&#44; the population<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>14 years of age totalled 106&#44;505 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">In order to optimize patient identification and avoid losses&#44; two independent data sources were used&#46; On the one hand&#44; information was requested from the 8 public hospitals in Asturias through the electronic data services of each of them&#46; On the other hand&#44; the data corresponding to the patients registered in the primary care centers of the 8 healthcare areas were requested through the electronic data services management center of Asturias&#46; The results obtained were then crossed and filtered&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Clinical histories in the region of Asturias are filed in electronic format&#46; The Millennium software application is used at Hospital Universitario Central de Asturias&#44; while the Selene application is used at all other hospitals&#46; The OMI&#95;AP program is used at the primary care centers&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Socio-demographic&#44; clinical and healthcare data were obtained from these clinical histories between March and June 2015&#46; A specific form was designed and a database was created for the input of the collected information&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The variables collected included gender&#44; age&#44; age at diagnosis&#44; date of birth and of diagnosis&#44; autoimmune diseases&#44; any family history of DM1 and type 2 diabetes mellitus &#40;DM2&#41;&#44; human resources &#40;physician and diabetes education nurse&#41;&#44; the use of advanced therapies &#40;continuous glucose monitoring systems &#91;CGMS&#93; and continuous subcutaneous insulin infusion &#91;CSII&#93;&#41;&#44; and healthcare data &#40;the healthcare area where treatment was received&#44; the frequency of controls&#44; health education interventions and the number of admissions&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">With regard to the personal history of DM1 and DM2&#44; we considered first-degree relatives &#40;parents&#41;&#44; second-degree relatives &#40;grandparents and siblings&#41;&#44; and third-degree relatives &#40;great-grandparents and uncles&#47;aunts&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Prevalence rates were calculated using data from the Spanish National Statistics Institute &#40;Instituto Nacional de Estad&#237;stica &#91;INE&#93;&#41; referring to Asturias&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">A descriptive analysis was made&#44; with frequency distributions for qualitative variables and the mean or median&#44; and dispersion measures such as the standard deviation &#40;SD&#41;&#44; for quantitative variables&#46; The analysis was performed using the R statistical package &#40;version 3&#46;3&#46;1&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Ethical and legal issues</span><p id="par0080" class="elsevierStylePara elsevierViewall">Authorization to carry out the study was requested from the Regional Clinical Research Ethics Committee of Asturias&#44; and from the manager of the Health Service of Asturias and managers of each of the 8 healthcare areas&#46; Likewise&#44; the research project was reported to the child administration authorities of Asturias&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The confidentiality and anonymity of the data used were ensured following the provisions of Organic Act 15&#47;1999 on Personal Data Protection and Spanish Royal Decree 1720&#47;2007&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0090" class="elsevierStylePara elsevierViewall">A total of 146 children under 15 years of age were found to have DM1 on 31 December 2014&#46; Of these&#44; 49&#46;3&#37; were girls &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>72&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The global prevalence was 1&#46;25 cases&#47;1000 children&#44; and by age groups 0&#46;21&#44; 1&#46;15 and 2&#46;40 cases&#47;1000 children in the age intervals 0&#8211;4&#44; 5&#8211;9 and 10&#8211;14 years&#44; respectively&#46; The gender distribution was 1&#46;23 cases&#47;1000 in boys and 1&#46;27 cases&#47;1000 in girls &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The mean age of the children with DM1 was 10&#46;51 years &#40;95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#46;99&#8211;11&#46;02&#41;&#44; with SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;14 and a median of 10&#46;8 years&#46; The mean age at the time of diagnosis was 6&#46;58 years &#40;95&#37;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;99&#8211;7&#46;16&#41;&#44; with SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;44 and a median of 6&#46;52 years&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">There were no statistically significant differences between the overall birth distribution in Asturias &#40;2000&#8211;2014&#41; and the birth distribution of children diagnosed with DM1 &#40;<span class="elsevierStyleItalic">X</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#46;4595&#59; df<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;09127&#41;&#46; Likewise&#44; no differences were observed between the distribution of the month of diagnosis and the distribution of births in Asturias &#40;<span class="elsevierStyleItalic">X</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;191&#59; df<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;2416&#41;&#46; The seasonal distributions of birth and of diagnosis are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">With regard to associated autoimmune diseases&#44; autoimmune thyroid disease was recorded in 8&#46;2&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41;&#44; of which 58&#46;3&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41; were girls&#44; while celiac disease was recorded in 6&#46;8&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41;&#44; of which 70&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41; were girls&#46; In relation to other diseases&#44; 8&#46;2&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41; had asthma and 13&#46;0&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41; suffered other conditions&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">A total of 14&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41; had one or more relatives with DM1 &#40;4&#46;1&#37; first degree&#44; 2&#46;0&#37; second degree and 8&#46;2&#37; third degree&#41;&#46; Furthermore&#44; 29&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>43&#41; had a family history of DM2 &#40;2&#46;0&#37; first degree&#44; 21&#46;9&#37; second degree and 5&#46;5&#37; third degree&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The distribution of the areas of residence and of the areas where specialized care is provided in relation to the different healthcare areas is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">The human resources involved in the specialized care of diabetic children were a pediatrician and a nurse in each of the following healthcare areas&#58; I&#44; II&#44; VI&#44; VII and VIII&#46; Healthcare area III had two pediatricians and two diabetes education nurses&#46; In healthcare area IV there were two pediatricians and two nurses&#44; while in healthcare area V there were 6 endocrinologists and three diabetes education nurses&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">With regard to the controls in specialized care&#44; of the 146 children&#44; 92 were controlled by the pediatrician and 34 by the endocrinologist&#46; In 20 cases the corresponding data could not be obtained&#46; In healthcare area V&#44; the children were seen by specialists in endocrinology and nutrition&#46; The data regarding the frequency of these controls was only available in 7 cases&#44; with a mean of once every 1&#46;86 months&#44; SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;69&#44; and a median of 2 months&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">All of the children received multiple dose insulin therapy &#40;MDI&#41;&#46; None of the medical records contained information regarding the use of continuous subcutaneous insulin infusion systems or continuous glucose monitoring systems&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">In 37&#46;7&#37; of the cases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>55&#41; the clinical history explicitly reported that health education interventions had been made&#58; 51 of them in specialized care&#44; two in primary care&#44; and two in both healthcare settings&#46; The type of intervention was specified in 17 cases&#58; diabetes education in 16 cases&#44; and diabetes education added to the visit of healthcare professionals to the school in one case&#46; In the remaining cases&#44; intervention was confirmed&#44; but no further details were provided&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">With regard to the number of admissions&#44; data were available on 83 patients who experienced one or more admissions&#44; including that corresponding to diabetes onset&#46; The mean number of admission was 1&#46;5&#44; with a SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;98&#44; and a median of one admission&#46; Of the 83 patients who were admitted to hospital&#44; the duration of admission was known in 29 cases&#44; with a mean of 8&#46;83 days&#44; SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;04&#44; and a median of 9 days&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">The present study recorded a prevalence of 1&#46;25 cases&#47;1000 children under 15 years of age&#44; which is consistent with the average reported by studies conducted in other Spanish regions&#44; the highest prevalence corresponding to Andalusia with 1&#46;7 cases&#47;1000 in a study conducted in 2013&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> while the lowest was recorded in a M&#233;rida healthcare area&#44; with 0&#46;95 cases&#47;1000&#44; in a study carried out in 2008&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> In Castilla y Le&#243;n the prevalence of DM1 was 1&#46;18 cases&#47;1000 children in 2004&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> This prevalence is similar to that recorded in Arag&#243;n in 2010&#44; with 1&#46;1 cases&#47;1000&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> a figure that increased to 1&#46;22 cases&#47;1000 in 2013&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> These prevalences are slightly lower than those reported in Castilla &#8211; La Mancha in 2008&#44; with 1&#46;44 cases&#47;1000&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> and in Cantabria&#44; where the mean prevalence between 1990 and 1996 was 1&#46;53 cases&#47;1000 children&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">As in other published studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">8&#44;11</span></a> the greatest prevalence corresponded to the 10&#8211;14 years of age group&#46; A greater total prevalence was seen in girls&#44; except in the 10&#8211;14 year interval where males predominated&#46; This is consistent with the results of the study conducted by Giralt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> where males predominated in all the groups&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Few prevalence studies are available&#44; and moreover their designs are heterogeneous&#46; The latest report from the International Diabetes Federation<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> indicates that the incidence of DM1 in children under 15 years of age is growing in many countries&#44; with an overall annual increase of approximately 3&#37;&#44; which implies an increased prevalence of the disease&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">There are no official registries of DM1 in the region of Asturias&#46; The creation of such registries is a prerequisite for understanding the epidemiology and for facilitating the better planning of socio-sanitary and educational resource utilization&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The children with DM1 were more often born in winter and spring&#44; unlike in Aragon<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> where the greatest number of births occurred in summer and the lowest in winter&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">In contrast to what is found in the literature&#44;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">13&#8211;15</span></a> we recorded more diagnoses in the summer and spring seasons than in winter and fall&#46; The results of our study are similar to those obtained in Castilla y Le&#243;n in 2003&#8211;2004&#44; where most of the cases were diagnosed in summer&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> In a recent study in Vizcaya&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> no differences were observed in the diagnosis of the disease between the four seasons&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">As has already been done in Arag&#243;n&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> it might be worth exploring the possible relationships between climatology and the history of infectious diseases to see if some link can be established&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">In our study&#44; autoimmune thyroid disease was the most prevalent autoimmune disorder associated with DM1&#44; as has also been reported in the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> There is an increased risk of thyroid alterations in people with DM1&#44; where the prevalence of thyroid disease is 10&#8211;22&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> In our study the prevalence was slightly lower &#40;8&#46;2&#37;&#41;&#46; According to the literature&#44; female gender appears to be a risk factor in this regard&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> In our study 58&#46;3&#37; of the patients with thyroid alterations were girls&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Craig et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> in a study conducted on three continents&#44; found the prevalence of celiac disease to be approximately 3&#46;5&#37; in children with diabetes&#44; and this figure appears to be greater in females than in males&#46; The observed prevalence of 6&#46;8&#37; is closer to that reported by Marqu&#233;s Valls et al&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> in Hospital Universitario Sant Joan de D&#233;u &#40;6&#46;4&#37;&#41; or by Maltoni et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> in a more recent study in northern Italy &#40;9&#46;8&#37;&#41;&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Only 6&#46;1&#37; of the children had a family history of DM1 in first or second degree relatives&#46; This percentage is lower than that reported in the literature&#44; where approximately 15&#8211;20&#37; of all people with DM1 were seen to have relatives with the disease&#46; In Cantabria&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> 15&#46;5&#37; had a history of DM1&#44; versus 19&#46;5&#37; in Arag&#243;n<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> and 26&#37; in a study conducted in Castilla y Le&#243;n&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> A study conducted in the Valme hospital recruitment area<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> reported a much higher figure &#40;43&#46;5&#37;&#41;&#46; No explanation for these differences can be found&#44; based on the data obtained&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">In our study&#44; 4&#46;1&#37; of the children had a history of first-degree relatives with DM1&#44; which differs from the 10 to 15&#37; reported worldwide but comes close to the 5&#37; reported in the study conducted in Castilla y Le&#243;n<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> and the 6&#46;4&#37; reported in Galicia&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">In turn&#44; 23&#46;9&#37; of the children had a history of first- or second-degree relatives with DM2&#44; which coincides with the data published for Castilla y Le&#243;n &#40;23&#46;9&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> In Arag&#243;n<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> the figure was significantly higher &#40;35&#46;3&#37;&#41;&#44; but still far from that reported by the Valme hospital recruitment area &#40;65&#46;3&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> In our study&#44; 2&#37; of the first-degree relatives had DM2&#44; this being similar to the 1&#46;8&#37; found in Galicia&#46; These data could be explained by the high prevalence of DM2 in Spain&#44; and by the fact that the disease is more frequent among elderly people&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">It should be noted that migration from one specialized care center to another does not follow the logical flow toward the reference center of the Autonomous Community in healthcare area IV&#46; Such migration could be explained by the type of care provided or by the link established between the parents and the healthcare professionals&#46; In healthcare area V the patients are seen by endocrinologists&#44; while in all the other healthcare areas pediatricians are in charge of patient control&#46; According to the Spanish Society of Pediatric Endocrinology&#44; accredited reference centers are required to offer the best care for children and adolescents&#44; with pediatric health professionals specifically trained in this field&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> At the time this study was carried out&#44; only healthcare area III in Asturias had a pediatric endocrinology unit&#46; The hospitals in the least populated healthcare areas see only a very small number of patients&#46; Following the current recommendations&#44; it might be advisable for these patients to be seen in accredited reference centers in order to ensure the best care possible&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Data regarding the frequency of the control visits could only be obtained in 7 cases&#46; It would be necessary to collect this information using other tools&#44; such as appointment coordination&#44; in order to know the data of the entire population and see whether all the healthcare areas were behaving in the same way&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">A number of authors have found CSII systems to be effective and safe in children because they allow good metabolic control to be achieved without an increase in adverse effects&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> These systems also afford advantages over multiple dosing&#44; such as optimal control&#44; reduce severe hypoglycemic events&#44; and are cost-effective&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> However&#44; despite all these advantages&#44; no children in our study were recorded to have benefited from this treatment modality during the study period&#46; The first child to start treatment with a CSII system did so in January 2015 in healthcare area V&#46; The analysis of the SWEET registry showed that of 16&#44;570 patients under 18 years of age&#44; 44&#46;4&#37; used CSII systems&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> A recent study in Andalusia yielded a figure of 5&#46;5&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">Continuous glucose monitoring systems &#40;CGMS&#41; offer demonstrated benefits in terms of glycemic control not only in patients treated with CSII&#44; but also in patients receiving multiple dose insulin therapy &#40;MDI&#41;&#44; and their use in children is recommended&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> However&#44; we found no data in the clinical histories referring to CGMS use as established on 31 December 2014&#46; This may have been due to deficiencies in the registries&#44; or possibly because up until that date their use in children was still very limited due to a lack of knowledge of these systems&#44; self-financing requirements&#44; or other undetermined circumstances&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Structured educational programs adapted to the age and development stage of the patients&#44; with due consideration of the family and social environment&#44; are a useful tool for improving the management of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> However&#44; fewer than 50&#37; of the clinical histories stated that educational measures had been adopted&#46; Furthermore&#44; the concrete measures taken were not specified&#44; and no evaluation of their effects was indicated&#46; It seems clear that at least at the onset of the disease&#44; all families should receive some type of diabetes education&#44; and here again the registries showed deficiencies despite their importance as tools for conducting follow-up and ensuring the continuity of patient care&#46; The clinical histories have a poor record of the interventions performed by nurses&#44; while interaction with the school environment is rarely taken into consideration&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">With regard to the number of admissions&#44; including those corresponding to disease onset&#44; we recorded an average of 1&#46;52 admissions per patient&#44; but this information could only be obtained in 83 cases&#46; It is surprising that not all the clinical histories reported admissions&#44; because all patients are admitted for care&#44; at least at the start of the disease&#46; The data recorded therefore might not adequately reflect the true situation&#44; and this could be explained by deficiencies in the transfer of the data contained in the old case histories in paper format to the new electronic systems&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">A possible limitation of this study concerns precision in the compilation of each variable&#46; The electronic clinical history system has only recently been introduced in Asturias&#46; In addition&#44; each healthcare area has digitized and entered the data of the old case histories in paper format to the current electronic databases in a different way&#46; Furthermore&#44; the software application of the reference hospital in the Autonomous Community differs from that used in the other hospitals in the region&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">In conclusion&#44; our study reports the first data on the prevalence of DM1 in children under 15 years of age in the region of Asturias&#46; It also offers information on human resources and healthcare data that illustrates the disparity in terms of the care received in the different healthcare areas of the region&#44; as well as the lack of use of advanced therapies&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0250" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1181612"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Material and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1102463"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1181613"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1102464"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material and methods"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Ethical and legal issues"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflicts of interest"
        ]
        9 => array:2 [
          "identificador" => "xack403414"
          "titulo" => "Acknowledgments"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-06-07"
    "fechaAceptado" => "2018-08-21"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1102463"
          "palabras" => array:4 [
            0 => "Type 1 diabetes mellitus"
            1 => "Epidemiology"
            2 => "Prevalence"
            3 => "Health resources"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1102464"
          "palabras" => array:4 [
            0 => "Diabetes mellitus tipo 1"
            1 => "Epidemiolog&#237;a"
            2 => "Prevalencia"
            3 => "Recursos en salud"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Prevalence of type 1 diabetes mellitus &#40;T1DM&#41; is increasing worldwide&#46; Care provided appears to have an influence on the course of disease&#46; The aim of this study was to ascertain the prevalence of T1DM and to collect data on the resources and care used in Asturias&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A descriptive&#44; cross-sectional study including patients born between 2000 and 2014 with diagnosis of T1DM at 31&#47;12&#47;2014&#46; Patients were identified using two independent data sources&#46; Information was collected from medical records&#46; A descriptive data analysis was performed to provide frequency distributions and measures of position and dispersion&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">146 patients were identified&#44; with a total prevalence of 1&#46;25&#47;1000 children&#46; Prevalence rates by age group were 0&#46;21&#44; 1&#46;15&#44; and 2&#46;40 by 1000 in children aged 0&#8211;4&#44; 5&#8211;9&#44; and 10&#8211;14 years respectively&#46; Autoimmune thyroid disorders and celiac disease were found in 8&#46;2&#37; and 6&#46;8&#37; respectively&#44; while 14&#46;4&#37; had a family history of T1DM and 29&#46;4&#37; of T2DM&#46; Ninety-two children were treated by pediatricians and 34 by endocrinologists&#46; All children were receiving multiple dose insulin treatment and none of them used self-monitoring blood glucose systems&#46; Health education was provided to 37&#46;7&#37; of children&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This study reports the first data on T1DM prevalence in children under 15 years old in Asturias and provides care data that show the disparity in care received depending on healthcare area&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de diabetes mellitus 1 &#40;DM1&#41; est&#225; aumentando en todo el mundo&#46; La atenci&#243;n recibida parece tener influencia en la evoluci&#243;n de la enfermedad&#46; El objetivo es conocer la prevalencia de DM1&#44; as&#237; como los recursos y datos asistenciales que se est&#225;n utilizando en Asturias&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo&#44; transversal&#44; siendo la poblaci&#243;n a estudio los nacidos entre el 2000 y el 2014&#44; con diagn&#243;stico de DM1 a 31&#47;12&#47;2014&#46; Se identific&#243; a los pacientes a trav&#233;s de dos fuentes de datos independientes&#46; La informaci&#243;n se recogi&#243; a trav&#233;s de las historias cl&#237;nicas&#46; Se realiz&#243; un an&#225;lisis descriptivo de los datos proporcionando distribuciones de frecuencias y medidas de posici&#243;n y dispersi&#243;n&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se identificaron 146 pacientes&#44; la prevalencia total fue de 1&#44;25&#47;1&#46;000 ni&#241;os&#46; Por grupos de edad fue de 0&#44;21&#59; 1&#44;15 y 2&#44;40 por cada 1&#46;000 en los ni&#241;os de 0-4&#59; 5-9 y 10-14 a&#241;os respectivamente&#46; El 8&#44;2&#37; presentaban alteraciones tiroideas autoinmunes y el 6&#44;8&#37; padec&#237;an enfermedad cel&#237;aca&#46; El 14&#44;4&#37; ten&#237;an antecedentes familiares de DM1 y el 29&#44;4&#37; de DM2&#46; Noventa y dos ni&#241;os eran atendidos por pediatras y 34 por endocrin&#243;logos&#46; El 100&#37; segu&#237;a terapia con m&#250;ltiples dosis de insulina y ninguno utilizaba sistemas de monitorizaci&#243;n continua de glucosa&#46; El 37&#44;7&#37; recibi&#243; educaci&#243;n para la salud&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Este estudio recoge los primeros datos de prevalencia de DM1 en menores de 15 a&#241;os en Asturias y aporta datos asistenciales que permiten dar cuenta de la disparidad en cuanto a la atenci&#243;n recibida seg&#250;n &#225;rea sanitaria&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Osorio &#193;lvarez S&#44; Riestra Rodr&#237;guez MR&#44; L&#243;pez S&#225;nchez R&#44; Alonso P&#233;rez F&#44; Oltra Rodr&#237;guez E&#46; Prevalencia y datos asistenciales de la diabetes mellitus tipo 1 en menores de 15 a&#241;os en Asturias&#46; Endocrinol Diabetes Nutr&#46; 2019&#59;66&#58;188&#8211;194&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">This article was previously submitted as an Oral Communication&#58; &#8220;Epidemiology of childhood diabetes in Asturias&#8221; at the IV International Congress and X National Congress of the Community Nursing Association &#40;Asociaci&#243;n de Enfermer&#237;a Comunitaria &#91;AEC&#93;&#41;&#44; Burgos&#44; 5&#8211;7 October 2016&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1376
            "Ancho" => 2511
            "Tamanyo" => 311744
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Healthcare map of Asturias with total population and population under 14 years of age&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">0&#8211;4 years</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">5&#8211;9 years</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">10&#8211;14 years</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46;&#176; cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prevalence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46;&#176; cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prevalence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46;&#176; cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prevalence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46;&#176; cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prevalence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Boys&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Girls&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2013738.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Prevalence of type 1 diabetes mellitus according to age and gender groups&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Season&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Birth</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnosis</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Spring&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Summer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Winter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No data&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2013740.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Seasonal distribution of births and diagnoses of type 1 diabetes mellitus&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Healthcare area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Healthcare area of residence</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Healthcare area where care is received</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Population &#60;14 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cases DM1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cases DM1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2249&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;323&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#44;586&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">VI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4558&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">VII&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5203&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">VIII&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6974&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No data&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;505&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2013739.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Distribution of areas of residence and areas where treatment is received in specialized care&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "International Diabetes Federation&#46; IDF diabetes atlas&#46; 8&#46;&#170; ed&#46; Bruselas&#44; B&#233;lgica&#59; 2017&#46;"
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio descriptivo de diabetes infantil en el &#225;rea de salud de M&#233;rida"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Gil"
                            1 => "R&#46; Real"
                            2 => "F&#46; Hamed"
                            3 => "C&#46; Gonz&#225;lez"
                            4 => "A&#46; Montero"
                            5 => "A&#46; Vilela"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Foro Pedi&#225;trico"
                        "fecha" => "2010"
                        "paginaInicial" => "8"
                        "paginaFinal" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Situaci&#243;n de la diabetes mellitus tipo 1 en Andaluc&#237;a&#46; Datos asistenciales&#44; uso de terapias avanzadas y recursos humanos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;P&#46; L&#243;pez Siguero"
                            1 => "O&#46; P&#233;rez Gonz&#225;lez"
                            2 => "A&#46;L&#46; G&#243;mez Gila"
                            3 => "I&#46; Leiva Gea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diabetes tipo 1 en ni&#241;os&#58; incidencia en Asturias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;F&#46; Rivas Crespo"
                            1 => "S&#46; Garc&#237;a del Real"
                            2 => "F&#46; D&#237;az Cad&#243;rniga"
                            3 => "G&#46; Casta&#241;o Fern&#225;ndez"
                            4 => "J&#46; Alonso Marquiegui"
                            5 => "J&#46; Prieto Santiago"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "An Esp Pediatr"
                        "fecha" => "1998"
                        "volumen" => "11"
                        "paginaInicial" => "62"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiolg&#237;a de la Diabetes tipo 1 en Asturias&#58; 2002&#95;2011"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46; Mayoral Gonz&#225;lez"
                            1 => "I&#46; Ria&#241;o Gal&#225;n"
                            2 => "C&#46; Rodr&#237;guez Dehli"
                            3 => "R&#46; Labra &#193;lvarez"
                            4 => "L&#46; D&#237;az Naya"
                            5 => "E&#46; Men&#233;ndez Torre"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.endinu.2017.10.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocrinol Diabetes Nutr"
                        "fecha" => "2018"
                        "volumen" => "65"
                        "paginaInicial" => "68"
                        "paginaFinal" => "73"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29373304"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Criteria for Centers of Reference for pediatric diabetes &#8211; a European perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Danne"
                            1 => "S&#46; Lion"
                            2 => "L&#46; Madaczy"
                            3 => "H&#46; Veeze"
                            4 => "F&#46; Raposo"
                            5 => "I&#46; Rurik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1399-5448.2012.00914.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Diabetes"
                        "fecha" => "2012"
                        "volumen" => "13"
                        "numero" => "Suppl&#46; 16"
                        "paginaInicial" => "62"
                        "paginaFinal" => "75"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22931225"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Heterogeneity in the systems of pediatric diabetes care across the European Union"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Cinek"
                            1 => "Z&#46; Sumn&#237;K"
                            2 => "C&#46; de Beaufort"
                            3 => "I&#46; Rurik"
                            4 => "A&#46; Vazeou"
                            5 => "L&#46; Mad&#225;csy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1399-5448.2012.00907.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Diabetes"
                        "fecha" => "2012"
                        "volumen" => "13"
                        "numero" => "Suppl&#46; 16"
                        "paginaInicial" => "5"
                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22931219"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and prevalence of type 1 diabetes in children aged<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>15 yr in Castilla-Leon &#40;Spain&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;P&#46; Bah&#237;llo"
                            1 => "F&#46; Hermoso"
                            2 => "C&#46; Ochoa"
                            3 => "J&#46;A&#46; Garc&#237;a-Fern&#225;ndez"
                            4 => "J&#46; Rodrigo"
                            5 => "J&#46;M&#46; Marug&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1399-5448.2007.00255.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Diabetes"
                        "fecha" => "2007"
                        "volumen" => "8"
                        "paginaInicial" => "369"
                        "paginaFinal" => "373"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18036062"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Registro de diabetes mellitus tipo 1 en Arag&#243;n&#58; 20 a&#241;os de seguimiento"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Conde Barreiro"
                            1 => "M&#46; Rodr&#237;guez Rigual"
                            2 => "M&#46; Bueno Lozano"
                            3 => "M&#46;P&#46; Rodrigo Val"
                            4 => "M&#46;L&#46; Comp&#233;s Dea"
                            5 => "J&#46; Soria Aznar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Endocrinol Pediatr"
                        "fecha" => "2013"
                        "volumen" => "4"
                        "paginaInicial" => "13"
                        "paginaFinal" => "21"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Servicio Aragon&#233;s de Salud&#46; Diabetes Mellitus Tipo 1 en menores de 15 a&#241;os Arag&#243;n 1991&#8211;2013&#46; Arag&#243;n&#58; Gobierno de Arag&#243;n&#59; 2015&#46;"
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio epidemiol&#243;gico de la diabetes tipo 1&#44; en menores de 15 a&#241;os en Castilla-La Mancha"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Giralt Mui&#241;a"
                            1 => "M&#46;J&#46; Ballester Herrera"
                            2 => "E&#46; Palomo Atance"
                            3 => "J&#46;J&#46; Angulo Donado"
                            4 => "G&#46; S&#225;nchez"
                            5 => "L&#46; Santillana Ferrer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2012"
                        "volumen" => "76"
                        "paginaInicial" => "83"
                        "paginaFinal" => "91"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aspectos epidemiol&#243;gicos de la diabetes mellitus tipo 1"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Luzuriaga"
                            1 => "M&#46; San Rom&#225;n"
                            2 => "A&#46; Argumosa"
                            3 => "L&#46; Casta&#241;o"
                            4 => "R&#46; Bilbao"
                            5 => "F&#46; Leyva-Cobi&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Bol Pediatr&#237;a"
                        "fecha" => "2002"
                        "volumen" => "42"
                        "paginaInicial" => "283"
                        "paginaFinal" => "295"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio de estacionalidad en los pacientes diagnosticados de diabetes mellitus tipo 1 en Arag&#243;n&#46; Influencia de factores climatol&#243;gicos y microbiol&#243;gicos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Conde Barreiro"
                            1 => "M&#46; Rodr&#237;guez Rigual"
                            2 => "G&#46; Bueno Lozano"
                            3 => "B&#46; Gonz&#225;lez Pelegr&#237;n"
                            4 => "M&#46; Ome&#241;aca Ter&#233;s"
                            5 => "M&#46;P&#46; Rodrigo Val"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Endocrinol Pediatr"
                        "fecha" => "2015"
                        "volumen" => "6"
                        "paginaInicial" => "25"
                        "paginaFinal" => "38"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidencia de diabetes mellitus tipo 1 en ni&#241;os&#58; resultados del registro poblacional de la Comunidad de Madrid&#44; 1997&#8211;2005"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46; Zorrilla Torras"
                            1 => "J&#46;L&#46; Cantero Real"
                            2 => "R&#46; Barrios Castellanos"
                            3 => "J&#46; Ram&#237;rez Fern&#225;ndez"
                            4 => "J&#46; Argente Oliver"
                            5 => "A&#46; Gonz&#225;lez Vergaz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2009"
                        "volumen" => "132"
                        "paginaInicial" => "545"
                        "paginaFinal" => "548"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seasonality at the clinical onset of type 1 diabetes-Lessons from the SWEET database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Gerasimidi Vazeou"
                            1 => "O&#46; Kordonouri"
                            2 => "M&#46; Witsch"
                            3 => "J&#46;M&#46; Hermann"
                            4 => "G&#46; Forsander"
                            5 => "C&#46; Beaufort"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/pedi.12433"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Diabetes"
                        "fecha" => "2016"
                        "volumen" => "17"
                        "numero" => "Suppl&#46; 23"
                        "paginaInicial" => "32"
                        "paginaFinal" => "37"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28334496"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "&#91;tesis doctoral&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiolog&#237;a de la diabetes tipo 1 infantil en Castilla y Le&#243;n 2003&#8211;2004"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;P&#46; Bah&#237;llo Curieses"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2006"
                        "editorial" => "Universidad de Valladolid"
                        "editorialLocalizacion" => "Valladolid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of childhood-onset type 1 diabetes in Biscay&#44; Spain&#44; 1990&#8211;2013"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Fern&#225;ndez-Ramos"
                            1 => "E&#46; Arana-Arri"
                            2 => "P&#46; Jim&#233;nez Huertas"
                            3 => "A&#46; Vela"
                            4 => "I&#46; Rica"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/pedi.12354"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Diabetes"
                        "fecha" => "2017"
                        "volumen" => "18"
                        "paginaInicial" => "71"
                        "paginaFinal" => "76"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26782628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Descripci&#243;n de las enfermedades autoinmunes acompa&#241;antes de la diabetes mellitus tipo 1 en un &#225;rea sanitaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Villar-Guerra"
                            1 => "D&#46; Luis-Rom&#225;n"
                            2 => "M&#46; Gonz&#225;lez-Sagrado"
                            3 => "J&#46;C&#46; Hernando-Mayor"
                            4 => "F&#46; Centeno-Malfaz"
                            5 => "R&#46; Villar-Gal&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Av Diabetol"
                        "fecha" => "2015"
                        "volumen" => "31"
                        "paginaInicial" => "30"
                        "paginaFinal" => "35"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thyroid autoimmunity in Type 1 diabetes&#58; systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46;B&#46; Shun"
                            1 => "K&#46;C&#46; Donaghue"
                            2 => "H&#46; Phelan"
                            3 => "S&#46;M&#46; Twigg"
                            4 => "M&#46;E&#46; Craig"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/dme.12318"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabet Med"
                        "fecha" => "2014"
                        "volumen" => "31"
                        "paginaInicial" => "126"
                        "paginaFinal" => "135"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24103027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of celiac disease in 52&#44;721 youth with type 1 diabetes&#58; International comparison across three continents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;E&#46; Craig"
                            1 => "N&#46; Prinz"
                            2 => "C&#46;T&#46; Boyle"
                            3 => "F&#46;M&#46; Campbell"
                            4 => "T&#46;W&#46; Jones"
                            5 => "S&#46;E&#46; Hofer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2337/dc16-2508"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes Care"
                        "fecha" => "2017"
                        "volumen" => "40"
                        "paginaInicial" => "1034"
                        "paginaFinal" => "1040"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28546222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asociaci&#243;n entre la diabetes mellitus de tipo 1 y la enfermedad cel&#237;aca&#58; 6 a&#241;os de cribado serol&#243;gico sistem&#225;tico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Marqu&#232;s Valls"
                            1 => "M&#46; Molero Luis"
                            2 => "M&#46; Tondo Colomer"
                            3 => "M&#46; Hen&#225;ndez Garc&#237;a"
                            4 => "P&#46; Vilar Escrigas"
                            5 => "V&#46; Cusi S&#225;nchez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Lab Clin"
                        "fecha" => "2009"
                        "volumen" => "2"
                        "paginaInicial" => "65"
                        "paginaFinal" => "72"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of celic disease in 52&#44;721 youth with type 1 diabetes&#58; international comparison across three continents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Maltoni"
                            1 => "R&#46; Franceschi"
                            2 => "G&#46; D&#8217;Annunzio"
                            3 => "S&#46; Toni"
                            4 => "I&#46; Rabbone"
                            5 => "S&#46; Zucchini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2337/dc17-1348"
                      "Revista" => array:5 [
                        "tituloSerie" => "Diabetes Care"
                        "fecha" => "2017"
                        "volumen" => "40"
                        "paginaInicial" => "e167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29061595"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "&#91;tesis doctoral&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Caracter&#237;sticas cl&#237;nicas y epidemiol&#243;gicas de la poblaci&#243;n pedi&#225;trica diagnosticada de diabetes mellitus tipo 1&#46; 20 a&#241;os de evoluci&#243;n en Cantabria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;L&#46; Bertholt Zuber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2016"
                        "editorial" => "Universidad de Cantabria&#59;"
                        "editorialLocalizacion" => "Santander"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Debut de diabetes mellitus tipo 1 en el &#225;rea hospitalaria de Valme"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46; Camacho Magri&#241;an"
                            1 => "A&#46; Manzanares Rodr&#237;guez"
                            2 => "R&#46; Espino Aguilar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Vox Paediatrica"
                        "fecha" => "2012"
                        "volumen" => "XIX"
                        "paginaInicial" => "9"
                        "paginaFinal" => "13"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidencia y caracter&#237;sticas cl&#237;nicas al manifestarse la diabetes mellitus tipo 1 en ni&#241;os de Galicia &#40;Espa&#241;a&#44; 2001&#8211;2002&#41;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Grupo de diabetes Infantil de Galicia&#46;"
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Cepedano Dans"
                            1 => "J&#46; Barreiro Conde"
                            2 => "P&#46; Arias"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2005"
                        "volumen" => "62"
                        "paginaInicial" => "123"
                        "paginaFinal" => "127"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "335&#46;e1&#8211;335&#46;e4"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asistencia al ni&#241;o y adolescente con diabetes&#46; Unidades de referencia en diabetes pedi&#225;trica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Hermoso L&#243;pez"
                            1 => "R&#46; Barrio Castellanos"
                            2 => "B&#46; Garcia Cuartero"
                            3 => "A&#46; G&#243;mez Gila"
                            4 => "I&#46; Gonz&#225;lez Casado"
                            5 => "M&#46; Oyarzabal Irigoyen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2013"
                        "volumen" => "78"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Infusi&#243;n subcut&#225;nea continua de insulina en menores de 6 a&#241;os&#58; evoluci&#243;n a largo plazo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Colino"
                            1 => "M&#46; Mart&#237;n Fr&#237;as"
                            2 => "B&#46; Rold&#225;n"
                            3 => "M&#46;A&#46; &#193;lvarez"
                            4 => "R&#46; Yelmo"
                            5 => "R&#46; Barrio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2017"
                        "volumen" => "87"
                        "paginaInicial" => "276"
                        "paginaFinal" => "283"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Documento de posicionamiento sobre la eficiencia de las tecnolog&#237;as aplicadas al manejo de la diabetes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Mart&#237;n-Vaquero"
                            1 => "M&#46;A&#46; Mart&#237;nez-Brocca"
                            2 => "J&#46;M&#46; Garc&#237;a-L&#243;pez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.endonu.2014.08.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocrinol Nutr"
                        "fecha" => "2014"
                        "volumen" => "61"
                        "paginaInicial" => "e45"
                        "paginaFinal" => "e63"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25453400"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Insulin pump therapy in children with tupe 1 diabetes&#58; analysis of data from the SWEET registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Szypowska"
                            1 => "A&#46; Schwandt"
                            2 => "J&#46; Svensson"
                            3 => "S&#46; Sshalitin"
                            4 => "R&#46; Cardona-Hernandez"
                            5 => "G&#46; Forsander"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Pediatr Diabetes"
                        "fecha" => "2016"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Desarrollo de un programa educativo estructurado en diabetes para pacientes pedi&#225;tricos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Armengol"
                            1 => "M&#46; Losada"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Av Diabetol"
                        "fecha" => "2010"
                        "volumen" => "26"
                        "paginaInicial" => "203"
                        "paginaFinal" => "207"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack403414"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0255" class="elsevierStylePara elsevierViewall">We would like to thank Tania Iglesias &#40;statistics consultancy of the University of Oviedo&#41; and Marta Osorio &#40;collaboration in the translation&#41;&#46; Likewise&#44; thanks are due to Dr&#46; Isolina Ria&#241;o for her generosity and disinterested collaboration in reviewing the manuscript&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/25300180/0000006600000003/v1_201904190633/S253001801930037X/v1_201904190633/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64496"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/25300180/0000006600000003/v1_201904190633/S253001801930037X/v1_201904190633/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S253001801930037X?idApp=UINPBA00004N"
]
Article information
ISSN: 25300180
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 6 0 6
2024 October 30 3 33
2024 September 51 3 54
2024 August 19 2 21
2024 July 17 5 22
2024 June 14 3 17
2024 May 17 0 17
2024 April 29 0 29
2024 March 8 8 16
2024 February 22 4 26
2024 January 34 4 38
2023 December 21 10 31
2023 November 26 7 33
2023 October 16 2 18
2023 September 5 3 8
2023 August 10 3 13
2023 July 13 4 17
2023 June 15 2 17
2023 May 16 0 16
2023 April 17 3 20
2023 March 19 1 20
2023 February 18 6 24
2023 January 20 3 23
2022 December 20 7 27
2022 November 16 6 22
2022 October 20 8 28
2022 September 8 7 15
2022 August 13 9 22
2022 July 17 11 28
2022 June 14 6 20
2022 May 34 14 48
2022 April 18 4 22
2022 March 28 6 34
2022 February 39 8 47
2022 January 47 7 54
2021 December 29 9 38
2021 November 39 9 48
2021 October 32 11 43
2021 September 28 8 36
2021 August 50 9 59
2021 July 29 10 39
2021 June 24 7 31
2021 May 52 16 68
2021 April 84 29 113
2021 March 58 8 66
2021 February 35 6 41
2021 January 26 14 40
2020 December 17 11 28
2020 November 21 9 30
2020 October 14 7 21
2020 September 17 8 25
2020 August 19 6 25
2020 July 16 9 25
2020 June 14 3 17
2020 May 13 7 20
2020 April 7 3 10
2020 March 6 2 8
2020 February 8 1 9
2020 January 6 5 11
2019 December 13 4 17
2019 November 5 1 6
2019 October 9 5 14
2019 September 2 7 9
Show all

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos