Endocrine Abstracts

Introduction: The incidence of diabetes is increasing worldwide and type 2 diabetes in younger people is a growing phenomenon. From 1998 we have studied 21 subjects with early onset type 2 diabetes.
Methods:11 subjects(7 males) with type 2 diabetes, age 23.7 plus/minus 1.01 years and 10 subjects(8 males) age 35.4 plus/minus 11.7 years were studied with an insulin modified (0.05 unit per kg ) intravenous glucose tolerance test. BMI was 34.3 plus/minus 1.4 kg per m² v. 37.3 plus/minus 2.2 kg per m². The duration of diabetes was 2.9 plus/minus 0.8 years versus 1.7 plus/minus 0.44 years with mean age at diagnosis of 20.5 plus/minus 1.6 years v. 33.1 plus/minus 1.4 years. Systolic Blood Pressure was 129.1 plus/minus 4.9mmHg v. 141 plus/minus 5.8 mmHg. Diastolic BP was 79 plus/minus 2.4mmHg v.86 plus/minus 4.02 mmHg. Waist: hip ratio for all was 1.01 plus/minus 0.02. 80% of both groups had a positive family history of diabetes. Mean total cholesterol was 4.76 plus/minus 0.34mM v. 4.74 plus/minus mM, HDL cholesterol was 1.0 plus/minus 0.04mM v 0.95 plus/minus 0.07mM;LDL cholesterol was 3.35 plus/minus 0.34mM v 2.4 plus/minus 0.26mM; trigylcerides were 2.07 plus/minus 0.35mM v 3.3 plus/minus 0.8mM. Mean HbA1c was 8.4 plus/minus 0.54% versus 7.9 plus/minus 0.6% on a combination of oral hypoglycaemic agents and/or insulin. All subjects had hyperinsulinaemia with fasting serum insulin concentrations of 27.5 plus/minus 5.8microU per ml v. 23.3 plus/minus 3.7microU per ml with a plasma glucose of 11.1 plus/minus 1.13mM v.9.3 plus/minus 0.9mM. Acanthosis nigricans was present in 1 subject of each group. All subjects were markedly insulin resistant and had blunted first phase insulin secretion. GAD antibodies were negative.Microvascular complications were present in 19% of all patients.
Conclusion:
Early onset type 2 diabetes is characterised by obesity, positive family history of diabetes, dyslipidaemia and severe insulin resistance. These patients pose a major challenge for future public health strategy.