Endocrine Abstracts (2011) 27 OC4.2

White UK children are older, more obese and more insulin resistant than non-White UK children at diagnosis of type 2 diabetes: baseline results of the UK national type 2 diabetes cohort

Timothy Barrett2, Zoe Gray1, Emma Ilsley2, Catherine Cotter1, Anna Ford3, Kelly Turner4, James Heywood4, Anthony Barnett2, David Dunger4, Julian Hamilton-Shield5 & Jeremy Wales6

1Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, West Midlands, UK; 2University of Birmingham, Birmingham, West Midlands, UK; 3Sheffield Children’s Hospital, Sheffield, Yorkshire, UK; 4University of Cambridge, Cambridge, Cambridgeshire, UK; 5University of Bristol, Bristol, Somerset, UK; 6University of Sheffield, Sheffield, Yorkshire, UK.

Type 2 diabetes (T2DM) has increased in UK children since the first reports in 2000; however it is poorly characterised and management practice varies across the UK. We aimed to describe the characteristics of the first 103 children recruited to a national study. We wrote to paediatricians asking for children with: diagnosis of T2DM; body mass index (BMI) above 85th centile for age and sex; and other diagnoses such as monogenic diabetes excluded. Clinical data was collected into a national database. Blood was taken for diabetes antibody status. We were notified of 250 affected children and have consented 103 so far. Ten proved antibody positive so were excluded. Of the remainder, the M:F ratio was 1:2.5 and 52% were non-white UK origin (mainly from the South Asian subcontinent). Females were younger at diagnosis (F 11.9 years (S.D. 1.6) vs M 15.8 years (S.D. 1.1); P<0.001); and less obese (F mean BMI-Z score 2.76 (S.D. 0.69) vs M BMI-Z 3.24 (S.D. 0.88); P<0.02. There was a trend for non-white children to be younger at diagnosis (mean 12.5 years (S.D. 2.3) vs 13.2 years (S.D. 2.2); P=0.07); and less obese than white UK children (mean BMI-Z score 2.68 (S.D. 0.85) vs 3.10 (S.D. 0.71); P<0.01. For all the groups, children had fasting or post prandial C-peptide measurements within (50%) or above (50%) the cut points for normal range. White UK children are older at diagnosis than non-White children, more obese, and probably more insulin resistant. 50% of children still have raised C-peptide levels soon after diagnosis of diabetes. This raises the possibility of therapeutic intervention to preserve pancreatic beta cell function early in the disease process.