Endocrine Abstracts (2002) 3 P108

Paediatric diabetes survey shows type 2 diabetes prevalence 0.4%, distinct from type 1, and associated with overweight, puberty, female sex and ethnic minority status

TG Barrett1,2, S Ehtisham1,2, A Smith3 & AT Hattersley4

1Birmingham Children's Hospital, Birmingham, UK; 2University of Birmingham, Birmingham, UK; 3Diabetes UK, London, UK; 4University of Exeter, Exeter, UK

Most children with diabetes are insulin deficient (type 1). We have reported type 2 diabetes in children, defined by evidence of insulin resistance, but the prevalence and characteristics in UK children is unknown. We aimed to characterise and determine the prevalence of non-type 1 diabetes in the UK. The British Society for Paediatric Endocrinology and Diabetes Clinical Trials unit undertook a cross-sectional questionnaire survey of all paediatric diabetes centres during 2000, collecting data on presentation, clinical characteristics, and investigations. 177/228 centres responded (75%), and manage 15,255 diabetics under 16 years. They provided data on 113 children with non-type 1 diabetes (0.8%). 25 had type 2 diabetes (0.2%), of whom 8 presented in 2000 (0.4%). 24 had MODY, 45 had diabetes secondary to other conditions, and 19 unknown. We compared type 2 diabetes to type 1 (comparative data from National Paediatric Diabetes Audit of 7545 children, and other published data). Type 2 vs type 1: age of presentation 12.8yrs (SD3yrs) vs 7.1yrs (SD4yrs)(p<0.001); female 75% vs 49% (p<0.001); ethnic minority 64% vs 8.8% (p<0.001); family history of diabetes 80% vs 13% (p<0.001); overweight 96% vs 35% (p<0.001); ketones at presentation 16% vs 27%, NS. Type 2 diabetes may mimic type 1 with ketones at presentation, but is distinguished from type 1 and MODY by the presence of insulin resistance.

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