3 research outputs found
Characteristics of Turkish children with Type 2 diabetes at onset: a multicentre, cross-sectional study
Aims To describe the baseline clinical and laboratory findings and
treatment modalities of 367 children and adolescents diagnosed with Type
2 diabetes in various paediatric endocrinology centres in Turkey.
Methods A standard questionnaire regarding clinical and laboratory
characteristics at onset was uploaded to an online national database
system. Data for 367 children (aged 6-18 years) newly diagnosed with
Type 2 diabetes at 37 different paediatric endocrinology centres were
analysed. Results After exclusion of the children with a BMI Z-score < 1
SD, those with genetic syndromes associated with Type 2 diabetes, and
those whose C-peptide and/or insulin levels were not available, 227
cases were included in the study. Mean age was 13.8 +/- 2.2 (range
6.5-17.8) years, with female preponderance (68\%). Family history of
Type 2 diabetes was positive in 86\% of the children. The mean BMI was
31.3 +/- 6.5 kg/m(2) (range 18.7-61) and BMI Z-score was 2.4 +/- 0.8
(range 1-5). More than half (57\%) of the children were identified by an
opportunistic diabetes screening due to existing risk markers without
typical symptoms of diabetes. Only 13\% (n = 29) were treated solely by
lifestyle modification, while 40.5\% (n = 92) were treated with
metformin, 13\% (n = 30) were treated with insulin, and 33.5\% (n = 76)
were treated with a combination of insulin and metformin initially. Mean
HbA(1C) levels of the insulin and combination of insulin and metformin
groups were 98 (11.1\%) and 102 mmol/mol (11.5\%), respectively, and
also were significantly higher than the lifestyle modification only and
metformin groups mean HbA(1C) levels (70(8.6\%) and 67 mmol/mol (8.3\%),
respectively). Conclusions An opportunistic screening of children who
are at high risk of Type 2 diabetes is essential, as our data showed
that > 50\% of the children were asymptomatic at diagnosis. The other
important result of our study was the high rate of exclusion from the
initial registration (38\%), suggesting that accurate diagnosis of Type
2 diabetes in youth is still problematic, even for paediatric
endocrinologists