An observational study of type 2 diabetes within a large Australian tertiary hospital pediatric diabetes service.

Publisher: Munksgaard Country of Publication: Denmark NLM ID: 100939345 Publication Model: Print Cited Medium: Internet ISSN: 1399-5448 (Electronic) Linking ISSN: 1399543X NLM ISO Abbreviation: Pediatr Diabetes Subsets: MEDLINE

Original Publication: Copenhagen : Munksgaard, c2000-

Diabetes Mellitus, Type 2/*epidemiology; Adolescent ; Albuminuria/etiology ; Australia/epidemiology ; Body Mass Index ; Child ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/therapy ; Dyslipidemias/etiology ; Female ; Glycated Hemoglobin/metabolism ; Hospitals, Pediatric ; Humans ; Hypertension/complications ; Male

Background: Type 2 diabetes mellitus (T2DM) is emerging as a significant clinical problem within the pediatric population.
Objective: The objective of this study was to identify patients with T2DM in a large tertiary hospital diabetes service and examine aspects relating to clinical course and management.
Methods: An initial audit of our diabetes service (over 6 yr) was followed by a 2-yr period of prospective case ascertainment to identify patients with T2DM. Comprehensive data collection was then undertaken in these individuals.
Results: Within our service (n = 1574), 33 young people with T2DM were identified. Significant levels of co-morbidity were evident - dyslipidaemia (56%), microalbuminuria (45%), hypertension (30%) and abnormal retinal findings (25%). Hypertension was more likely in those with greater initial and follow-up body mass index (BMI) [mean (SD) BMI: 36.3 (5.0) vs. 28.0 (6.3) kg/m(2) , p = 0.001, and 36.8 (5.3) vs. 28.5 (7.8) kg/m(2) , p = 0.007, respectively] and BMI standard deviation score (SDS) [mean (SD) BMI SDS: 2.34 (0.30) vs. 1.72 (0.66), p = 0.001, and 2.26 (0.31) vs. 1.38 (0.87), p < 0.001, respectively], whereas abnormal retinal findings were seen in those with higher HbA1c values at last appointment [geometric mean (range) 10.9 (8.4-13.6) vs. 7.4 (5.6-12.5)%, p = 0.01) and those with greater increases in HbA1c over time (+4.1 (3.1) vs. +0.2 (1.9)%, p = 0.009). Of the 33,9 (27%) were lost to follow-up.
Conclusions: At present, T2DM in youth remains a low burden on our services. Patients with this diagnosis, however, have significant problems that present a major challenge to the development of effective management strategies.
(© 2010 John Wiley & Sons A/S.)

0 (Glycated Hemoglobin A)
0 (hemoglobin A1c protein, human)

Date Created: 20100327 Date Completed: 20110311 Latest Revision: 20221207

20221213

10.1111/j.1399-5448.2010.00647.x

20337972