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.
09 - 11 Nov 2011
British Society for Paediatric Endocrinology and Diabetes