BSPED2010 Poster Presentations (1) (59 abstracts)
Type 2 diabetes in childhood: building a platform for interventions to prevent the progression to cardiovascular disease
A Barnett 1 , T Barrett 1 , C Cotter 1 , D Dunger 3 , E Fulton 3 , J Heywood 3 , E Ilsley 1 , A O’Brien 2 , J Shield 2 & J Wales 4
1University of Birmingha, Birmingham, UK; 2University of Bristol, Bristol, UK; 3University of Cambridge, Cambridge, UK; 4University of Sheffield, Sheffield, UK.
Type 2 diabetes (T2DM) is increasing in children in the UK and worldwide, most likely related to the rising prevalence of obesity. We are developing a UK national cohort of children (under 18 completed years) with diabetes defined by WHO criteria, suspected type 2, BMI above 85th centile; but who do not have genetically confirmed monogenic diabetes, secondary diabetes, or any evidence of pancreatic autoimmunity. The aim of this study is to describe the characteristics of the first 30 children recruited.
After writing to all consultants with an interest in paediatric diabetes, we were notified of 234 children fulfilling the inclusion criteria. Clinical data was collected by a standardized case report form and checked for consistency before loading onto a database. So far, we have details on 30 children. The median age at diagnosis of T2DM was 11.4 years (range 7.9–16.9 years), and the duration of diabetes is 2.8 years. The M:F ratio is 1:3, and 50% are from non-white UK ethnic origin. Only 2 children are prepubertal. Five children (20%) were identified coincidentally or with no symptoms; one child presented in diabetic ketoacidosis. No child is recorded with retinopathy, but out of 10 children screened for nephropathy, 4 have microalbuminuria. While almost all children (90%) are taking metformin, there are 14 (50%) of children managed with insulin in addition. All 18 children with data on family history, had one or more first degree relatives affected with type 2 diabetes.
The data confirm that most children are pubertal or post pubertal at diagnosis, probably reflecting increased insulin resistance. Ethnic minorities are disproportionately represented. The proportion of children managed with insulin in addition to metformin is higher than in previous surveys. A positive family history for type 2 diabetes is very common and could represent a useful predictive marker for T2DM.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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