Presentation and course of Type 2 diabetes in youth in a large multi‐ethnic city

Zdravković, Vera; Daneman, Denis; Hamilton, Jill

doi:10.1111/j.1464-5491.2004.01297.x

Cited by 61 publications

(83 citation statements)

References 27 publications

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“…A recent study in children and adolescents with non‐alcoholic fatty liver disease reported a prevalence of impaired glucose tolerance of 23.4% and of Type 2 diabetes of 6.5% 27. Our finding of hypertension in 21% of children at diagnosis is consistent with other studies, which have reported rates of hypertension in adolescents of 10–55% at diagnosis 28, 29, although it was lower than the 34% rate reported in the 2005 cohort 30. In 11 cases no blood pressure data were available, therefore, cases of hypertension may have been missed.…”

Section: Discussionsupporting

confidence: 91%

Continuing rise of Type 2 diabetes incidence in children and young people in the UK

et al. 2018

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AimsTo estimate the incidence of Type 2 diabetes in children aged <17 years, compare this with similar data 10 years ago, and characterize clinical features at diagnosis in the UK and Republic of Ireland.MethodsUsing the British Paediatric Surveillance Unit reporting framework, cases of Type 2 diabetes diagnosed in children aged <17 years between 1 April 2015 and 30 April 2016 were reported each month.ResultsA total of 106 cases were reported, giving a UK incidence of 0.72/100 000 (95% CI 0.58–0.88). Children from ethnic minorities had significantly higher incidence compared with white children (0.44/100 000) with rates of 2.92/100 000 and 1.67/100 000, in Asian and BACBB (black/African/Caribbean/black British) children respectively. Sixty‐seven percent were girls and 81% had a family history of Type 2 diabetes. The mean BMI sd score at diagnosis was 2.89 (2.88, girls; 2.92, boys); 81% were obese. Children of Asian ethnicity had a significantly lower BMI sd score compared with white children (P<0.001). There was a trend in increased incidence from 2005 to 2015, with a rate ratio of 1.35 (95% CI 0.99–1.84), although this was not statistically significant (P=0.062). There was statistical evidence of increased incidence among girls (P=0.03) and children of South‐Asian ethnicity (P=0.01) when comparing the 2005 and 2015 surveys.ConclusionsType 2 diabetes remains far less common than Type 1 diabetes in childhood in the UK, but the number of cases continues to rise, with significantly increased incidence among girls and South‐Asian children over a decade. Female gender, family history, non‐white ethnicity and obesity were found to be strongly associated with the condition.

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Section: Discussionsupporting

confidence: 91%

Continuing rise of Type 2 diabetes incidence in children and young people in the UK

et al. 2018

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“…This is particularly the case in the USA [1, 2], but has also been reported in other countries [3,4,5]. The yearly number of newly documented manifestations of T2DM in children and adolescents has increased from 7 in 1992 to 38 in 2003 in standardized prospective documentation of children and adolescents with diabetes mellitus (dpv) in Germany and Austria [6].…”

Section: Introductionmentioning

confidence: 96%

Type 2 Diabetes in Children and Adolescents in a 2-Year Follow-Up: Insufficient Adherence to Diabetes Centers

et al. 2007

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Background/Aims: To study the 2-year course of children and adolescents with type 2 diabetes mellitus (T2DM) in general practice to present (1) the treatment modalities, (2) patient adherence, and (3) the occurrence of comorbidities. Methods: HBA1c, lipids, blood pressure, treatment modalities, occurrence of retinopathy and nephropathy were analyzed in 129 children and adolescents with T2DM (median age 13.4 years, 75% female) in specialized diabetes centers in Germany. Results: Seventy-eight (60%) children dropped out of care after a mean of 7.1 months. Drug treatment was not stopped in any of the 64 children initially treated with antidiabetic drugs. Sixteen (12%) children were treated solely by lifestyle intervention over the 2-year course. In the 51 children with complete follow-up, median HbA1c was 7.7% at diagnosis and 6.3% after 2 years. Less than 5% of all children were treated with antihypertensive or lipid-lowering drugs, while 65% suffered from hypertension and 44% from dyslipidemia. Over the course of the disease, retinopathy was not observed, while microalbuminuria occurred in 25%. Conclusions: In general practice, many children and adolescents with T2DM were lost of follow-up. Lifestyle intervention as sole treatment was not often useful for long-term metabolic control. Dyslipidemia and hypertension were seldom treated as recommended.

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“…Estimates of DKA prevalence at onset with type 2 diabetes vary substantially, from 41.4% and 16% among African-American youth in Cincinnati 14 and Arkansas, respectively, 13 to 8% among African Canadians and Southeast Asians in Toronto, 11 and 4.2% among Canadian Aboriginal youth. 12 We found that a higher prevalence of DKA was associated with younger age, minority race/ ethnicity, and male gender.…”

Section: Type 2 Diabetesmentioning

confidence: 99%

“…5 It has been reported to be present in 25% to 30% of type 1 diabetes cases at onset [6][7][8][9][10] and from 4% to 29% in youth with type 2 diabetes, depending on race/ethnicity. [10][11][12][13][14] SEARCH previously reported that the prevalence of DKA at diagnosis was 25.5% in 2002-2003. 10 It is not known whether the presence of DKA at diagnosis has changed over time.…”

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confidence: 99%

Trends in the Prevalence of Ketoacidosis at Diabetes Diagnosis: The SEARCH for Diabetes in Youth Study

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Diabetic ketoacidosis (DKA) is a life-threatening condition and often the presenting symptom of newly diagnosed type 1 or type 2 diabetes in youth. SEARCH previously reported that the prevalence of DKA at diagnosis was 25.5% in 2002-2003. WHAT THIS STUDY ADDS: DKA in youth with type 1 diabetes remains a problem, with almost one-third presenting with DKA. Among youth with type 2 diabetes, DKA was less common and decreased by ∼10% per year, suggesting improved detection or earlier diagnosis. abstract OBJECTIVE: To estimate temporal changes in the prevalence of diabetic ketoacidosis (DKA) at diagnosis of type 1 or type 2 diabetes in youth and to explore factors associated with its occurrence. METHODS:Five centers identified incident cases of diabetes among youth aged 0 to 19 years starting in 2002. DKA presence was defined as a bicarbonate level ,15 mmol/L and/or a pH ,7.25 (venous) or ,7.30 (arterial or capillary) or mention of DKA in the medical records. We assessed trends in the prevalence of DKA over 3 time periods (2002-2003, 2004-2005, and 2008-2010). Logistic regression was used to determine factors associated with DKA. RESULTS:In youth with type 1 diabetes (n = 5615), the prevalence of DKA was high and stable over time (30.2% in 2002-2003, 29.1% in 2004-2005, and 31.1% in 2008-2010; P for trend = .42). Higher prevalence was associated with younger age at diagnosis (P , .0001), minority race/ethnicity (P = .019), income (P = .019), and lack of private health insurance (P = 008). Among youth with type 2 diabetes (n = 1425), DKA prevalence decreased from 11.7% in 2002-2003 to 5.7% in 2008-2010 (P for trend = .005). Higher prevalence was associated with younger age at diagnosis (P = .001), minority race/ethnicity (P = .013), and male gender (P = .001). CONCLUSIONS:The frequency of DKA in youth with type 1 diabetes, although stable, remains high, indicating a persistent need for increased awareness of signs and symptoms of diabetes and better access to health care. In youth with type 2 diabetes, DKA at onset is less common and is decreasing over time. Pediatrics 2014;133:e938-e945 AUTHORS:

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Presentation and course of Type 2 diabetes in youth in a large multi‐ethnic city

Abstract: We report a similar increase in T2DM incidence and clinical presentation at HSC to other clinic reports in large North American urban centres. Of note is the high prevalence of children of South/South-East Asian descent.

Cited by 61 publications

References 27 publications

Continuing rise of Type 2 diabetes incidence in children and young people in the UK

Continuing rise of Type 2 diabetes incidence in children and young people in the UK

Type 2 Diabetes in Children and Adolescents in a 2-Year Follow-Up: Insufficient Adherence to Diabetes Centers

Trends in the Prevalence of Ketoacidosis at Diabetes Diagnosis: The SEARCH for Diabetes in Youth Study

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