ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 66 DS3.2 | DOI: 10.1530/endoabs.66.DS3.2

Type 2 diabetes, an increasing problem: lessons from national surveys

T Candler1,2 & JPH Shield1

1NIHR Biomedical Research Centre: Nutrition, Diet and Lifestyle Theme, School of Oral and Dental Sciences, Bristol, UK; 2MRC The Gambia at London School of Hygiene and Tropical Medicine, London, UK

Background: Type 2 Diabetes (T2DM), though a rare condition in children, is increasing in the paediatric population. The British Paediatric Surveillance Unit (BPSU) reporting framework is used to understand the clinical course and epidemiology of rare diseases in children.

Aim: To estimate the UK incidence of Type 2 diabetes (T2DM) in children aged <17 years and to compare with data collected a decade before. To characterize clinical features at diagnosis and assess the clinical progress 1-year on.

Methods: Clinician reported clinical data reported at presentation and 1-year follow-up of a cohort of children (<17 years) diagnosed with T2DM reported through the BPSU (April 2015–April 2016).

Results: The UK incidence of T2DM in children was 0.72/100 000 (95% CI 0.58–0.88) with children from ethnic minorities over-represented. Children of Asian ethnicity had a significantly lower BMI SDS compared with white children (P<0.001). There was a trend in increased incidence between 2005–2015, with a rate ratio of 1.35 (95% CI 0.99–1.84, P=0.062), however there was statistical evidence of increased incidence among girls (P=0.03) and children of South-Asian ethnicity (P=0.01). At 1-year follow up, HbA1c <48 mmol/mol was achieved in 38.8%. logHbA1c was predicted by clinician reported compliance and attendance concerns (β = 0.12, P = <0.0001) and change in body mass index (BMI) SDS at 1-year (β = 0.13, P=0.007). Metformin was the most frequently used treatment at baseline (77%) and follow-up (87%), though newer treatments like GLP-1 agonists were being used in children. Microalbuminuria prevalence at 1-year was 16.4% compared to 4.2% at baseline and was associated with a higher HbA1c compared to those without microalbuminuria (60 vs 49 mmol/mol, P = 0.03).

Conclusions: T2DM is an increasing especially among girls and those of south Asian ethnicity. Compliance to medication and BMI-reduction are key to positive outcomes.

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