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

Endocrine Abstracts (2019) 66 P38 | DOI: 10.1530/endoabs.66.P38

Remission rates, demographics and outcomes of paediatric patients with type 2 diabetes at a single centre: 2006-2018

Elizabeth Procter, James Law, Jennifer Calvert & Pooja Sachdev

Nottingham Children’s Hospital, Nottingham, UK

Background: Incidence of type 2 diabetes (T2DM) is increasing in children and young people under the age of 18 years. This group has a higher risk of microvascular complications and a more adverse cardiovascular risk profile than those diagnosed later. Weight loss is essential for remission, but intensive input is often required to achieve this.

Aims: 1. Describe the demographics of our T2DM population

2. Look at our remission rates

Methods: Patients were identified from a local database of patients with T2DM. Their hospital records were reviewed to identify baseline characteristics, treatment, progress and whether remission was achieved (n=34).

Results: Patients were most commonly female (38% male, 62% female), white (53% White, 35% Asian, 12% Black) and 75% had a family history of T2DM. Co-morbidities at baseline included polycystic ovary syndrome (n=4) and hypertension (n=7). Remission was achieved in nine and maintained in five (relapsed: n=3; unknown: n=1). Weight loss at remission was 8.0±3.3% and remains below baseline (7.6±4.2%, n=7) compared to the non-remission group, who have gained weight (1.8±11.2%, n=16). Patients who achieved remission most commonly opted for healthy eating and lifestyle management. One patient followed a supervised very low-calorie diet (<800 kcal/day) for six weeks followed by introduction of regular balanced meals.

Table 1 Characteristics of patients with T2DM at baseline, remission and present.
Age (years)15.5±0.814.7±2.00.08
Baseline BMI SDS3.29±3.9 (n=4)3.37±3.8 (n=10)
Baseline HbA1C77±2974±280.82
Remission BMI SDS1.48±1.07N/A
Current BMI SDS1.55±0.652.97±2.47
Current HbA1c39±5 mmol/l (n=8)73±28 mmol/l (n=20)

Conclusions: Remission is achieved in a minority of patients despite intensive input from hospital teams. Patients who achieved remission maintain a lower HbA1c and BMI SDS in comparison to the non-remission group, even if they have experienced a relapse. This demonstrates the importance and positive impact of weight loss, even if relapse occurs.

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