Type 2 diabetes in children and young adults in East London: an alarmingly high prevalence

Abstract

Type 2 diabetes (T2DM) in the young is a growing concern in many countries worldwide. In previous studies, positive associations with obesity, female gender, and family history have been noted. Newham, East London, has one of the highest prevalence of T2DM in the UK as well as one of the youngest populations. Our aim was to establish the prevalence and characteristics of T2DM in young people in Newham, and compare findings with existing data. Forty‐four young people (≤25 years) with T2DM and an equal number of young people with type 1 diabetes were examined. A retrospective analysis of existing patient records utilising diabetes and pathology databases was conducted. The age‐specific prevalence of T2DM in children and young adults within Newham was noted to be the highest in the UK at 0.57/1000 (58 out of 100 300). There was a strong association with obesity and 77% of those with T2DM were found to have a body mass index ≥25kg/m2. Many had features of the metabolic syndrome. This analysis confirms the high prevalence of T2DM with obesity in young people, particularly among minority ethnic groups, and adds to concern among health care providers and commissioners about the need for preventative strategies to tackle this problem. Copyright © 2012 John Wiley & Sons.

Prevalence of Hypertension and Albuminuria in Pediatric Type 2 Diabetes

“… 4 , 15 , 17 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 The reported age at diagnosis of type 2 diabetes ranged from 7.1 to 20.0 years, 46 , 47 , 49 , 72 and the duration of diabetes ranged from inclusion at diagnosis 40 , 41 , 43 , 51 , 52 , 55 , 56 ,…”

“…Thirty-one studies including 4363 patients with type 2 diabetes reported on the prevalence of hypertension defined as BP in the 95th percentile or greater for age, sex, and height or systolic BP 130 to 140 mm Hg or greater and diastolic BP of 80 to 90 mm Hg or greater. 4 , 15 , 17 , 40 , 41 , 42 , 43 , 44 , 45 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 72 , 73 , 74 The pooled prevalence of hypertension was 25.33% (95% CI, 19.57%-31.53%) ( Figure 1 ). High heterogeneity was noted across studies ( I 2 = 94%; P < .001).…”

“…The included studies had either a low (n = 27) 8 , 15 , 16 , 17 , 40 , 44 , 45 , 46 , 47 , 48 , 50 , 53 , 55 , 56 , 60 , 64 , 65 , 69 , 70 , 72 , 76 , 78 , 79 , 81 , 85 , 89 , 90 or moderate (n = 33) 4 , 41 , 42 , 43 , 49 , 51 , 52 , 54 , 57 , 58 , 59 , 61 , 62 , 63 , 66 , 67 , 68 , 71 , 73 , 74 , 75 , 77 , 80 , 82 , 83 , 84 , 86 , 87 , 88 , 91 , 92 , 93 , 94 risk of bias (eTable 11 and eFigure 21 in the…”

DAWN: Diabetes Appointments via Webcam in Newham

“…Consequently, we have a rising prevalence of type 2 diabetes in young people. 1 A population survey conducted by Ipsos MORI in 2009 showed that perceived lack of control, poor engagement with services and the lack of flexibility of services contributed to poor self-management with poor clinical outcomes and did-not-attend (DNA) rates for appointments. It was widely accepted that the diabetes service locally would be both unaffordable and undeliverable, given workforce and financial restrictions, unless new ways of delivering care could be found.…”

“…It was widely accepted that the diabetes service locally would be both unaffordable and undeliverable, given workforce and financial restrictions, unless new ways of delivering care could be found. 1 Since 2003, the local diabetes service has worked with a range of local partners, including primary care, to create an integrated care pathway. However, the service continued to have particularly high DNA rates (33-50% depending on age groups), reflecting the access challenges faced by many local patients.…”