Endocrine Abstracts

Background

Type 2 diabetes has traditionally been considered a disease affecting older age groups. In recent years, however, Type 2 diabetes has become increasingly common in children, adolescents and young adults.

Aim of the work

To estimate the prevalence of T2D among a sample of Egyptian youth aged (18–30) and to highlight the challenges in differentiating T1D from T2D in early onset diabetes depending on clinical and laboratory characteristics.

Methodology

Our cross sectional study was performed on two hundred newly diagnosed diabetic patients aged (18–30) years. All patients were subjected to full medical history and thorough clinical examination. Laboratory investigations included FBS, HbA1C, fasting C peptide and GADA. Patients with Medical disorders that would potentially confound results or patients receiving drugs that may affect blood glucose level as steroids were excluded from the study.

Results

About 59% (118) of our patients were T2D while (82) 41% were T1D. T1DM was more dominant than T2DM in age group less than 25 years (T1DM 79% vs T2DM 21%, P < 0.001), while T2DM was more than T1DM in age group more than 25 years (T2DM 93% vs T1DM 17%, P < 0.001). GADA was detected in 74 % of T1DM patient and it was high titer while GADA was detected in only 8% of T2DM with low titer, in addition GADA positive patients were significantly younger than negative patients, age (20.9 ± 2.5 years vs 26.4 ± 3.5 years respectively) (P < 0.001). C peptide was predominantly higher in T2D than T1D (1.4 ± 0.5 ng/ml T2D vs 0.7 ± 0.3 ng/ml T1D P < 0.001), but there was no difference in C peptide between GADA positive and negative neither T1DM nor T2DM patients. DKA was higher in T1DM than T2DM in both the GADA positive and GADA negative patients (92.7% in T1D, vs 5.1% in T2DM), but surprisingly higher in GADA negative than GADA positive in both T1DM and T2DM patients (P < 0.001). Also, family history of diabetes was more common in T2DM (T2DM 70.3% vs T1DM 26.8%, P < 0.001), history of autoimmune diseases was more common in T1DM (T1DM 18.3% vs T2DM 2.5%, P < 0.001).

Conclusion

The prevalence of diabetes mellitus especially T2D is increasing among youth may be due to changing lifestyle and genetic background, collection of detailed clinical and laboratory data has become fundamental to correctly evaluate diabetes trends in youth and to describe optimal treatment to different cases.