BSPED2012 Oral Communications Oral Communications 4 (5 abstracts)
White UK children are older, more obese and more insulin resistant than non-White UK children at diagnosis of type 2 diabetes: baseline results of the UK national type 2 diabetes cohort
Zoe Gray 1 , Emma Ilsley 2 , Catherine Cotter 1 , Lydiah Makusha 1 , Anna Ford 3 , Kelly Turner 4 , James Heywood 5 , Anthony Barnett 2 , David Dunger 5 , Julian Hamilton-Shield 6 , Jeremy Wales 7 & Timothy Barrett 2
1Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK; 2University of Birmingham, Birmingham, UK; 3Sheffield Children’s Hospital, Sheffield, UK; 4Royal London Hospital, London, UK; 5University of Cambridge, Cambridge, UK; 6University of Bristol, Bristol, UK; 7University of Sheffield, Sheffield, UK.
Objectives: 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 125 children recruited to the UK national study.
Methods: We recruited children with: paediatrician diagnosis of T2DM; body mass index (BMI) above 85th centile for age and sex; other diagnoses such as monogenic diabetes excluded. Clinical data was collected into a national database. Blood was taken for DNA and diabetes auto-antibody status.
Results: We were notified of 256 presumed affected children and have recruited 145 so far. Exclusions: auto-antibody positive (13); secondary diabetes (7). After exclusions M:F ratio was 1:2.6; white UK origin (49%); South Asian (SA) origin (29%); African-Caribbean (A-C) (12%); other (10%). Mean age at diagnosis was 13.2 yrs and mean duration of diabetes 3.0 years. White children were older at diagnosis (mean 13.4 years vs SA (13.2 years), A-C (12yrs; white vs A-C P<0.04)); fatter at diagnosis (BMI–SDS white (3.2), SA (2.8), A-C (2.7); white vs S-A P<0.01). White children trended towards lower HbA1c (white 9.2%, SA 8.7%, A-C 10.5%); and higher fasting C-peptide (white 1594 pmol/l; SA 1229 pmol/l; A-C 935 pmol/l). 19% of A-C children had resting heart rate more than 2 SD’s above the mean, vs 8% in SA and 7% in white children. There were no significant differences in resting blood pressure between groups.
Conclusion: White UK children are older at diagnosis than non-White children, more obese, and probably more insulin resistant. African-Caribbean children have poorer metabolic control and signs of cardiovascular dysfunction compared to white and SA children. A significant proportion of children still have raised C-peptide levels soon after diagnosis of diabetes, raising the possibility of therapeutic intervention to preserve pancreatic beta cell function early in the disease process.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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