Demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes: differences and overlaps
Purpose Type 1 diabetes (T1D) is the most common type of diabetes in children, but the frequency of type 2 diabetes (T2D) is increasing rapidly. Classification of diabetes is based on a constellation of features that vary by type. We aimed to compare demographic, clinical, and laboratory characteris...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Pediatric Endocrinology
2021-10-01
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| Series: | Annals of Pediatric Endocrinology & Metabolism |
| Subjects: | |
| Online Access: | http://e-apem.org/upload/pdf/apem-2142170-085.pdf |
| _version_ | 1818469710047477760 |
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| author | Teresa Nieto Beatriz Castillo Jacobo Nieto Maria J. Redondo |
| author_facet | Teresa Nieto Beatriz Castillo Jacobo Nieto Maria J. Redondo |
| author_sort | Teresa Nieto |
| collection | DOAJ |
| description | Purpose Type 1 diabetes (T1D) is the most common type of diabetes in children, but the frequency of type 2 diabetes (T2D) is increasing rapidly. Classification of diabetes is based on a constellation of features that vary by type. We aimed to compare demographic, clinical, and laboratory characteristics at diagnosis of pediatric T1D and T2D. Methods We studied children who visited a large academic hospital in Houston, Texas (USA) with a new diagnosis of T2D (n=753) or T1D (n=758). We compared age, sex, race/ethnicity, presence of obesity, glucose, hemoglobin A1c, islet autoantibody positivity, C-peptide, and presence of diabetic ketoacidosis (DKA) at diabetes diagnosis. Results At diagnosis, children with T2D, compared with those with T1D, were older (13.6 years vs. 9.7 years), more likely female (63.2% vs. 47.8%), of racial/ethnic minority (91.1% vs. 42.3%), and obese (90.9% vs. 19.4%) and were less likely to have DKA (7.8% vs. 35.0%) and diabetes autoantibodies (5.5% vs. 95.4%). Children with T2D also had significantly lower glucose, lower hemoglobin A1c and lower C-peptide level (all comparisons, P<0.0001). In multiple logistic regression analysis, older age, racial/ethnic minority, obesity, higher C-peptide, and negative islet autoantibodies were independently associated with T2D (all, P<0.05), while sex, glucose, hemoglobin A1c, and DKA were not (model P<0.0001). Conclusions There are important demographic, clinical, and laboratory differences between T1D and T2D in children. However, none of the characteristics were unique to either diabetes type, which poses challenges to diabetes classification at diagnosis. |
| first_indexed | 2024-04-13T21:27:55Z |
| format | Article |
| id | doaj.art-a123a290edc741178ba3ef640a8a4612 |
| institution | Directory Open Access Journal |
| issn | 2287-1012 2287-1292 |
| language | English |
| last_indexed | 2024-04-13T21:27:55Z |
| publishDate | 2021-10-01 |
| publisher | Korean Society of Pediatric Endocrinology |
| record_format | Article |
| series | Annals of Pediatric Endocrinology & Metabolism |
| spelling | doaj.art-a123a290edc741178ba3ef640a8a46122022-12-22T02:29:16ZengKorean Society of Pediatric EndocrinologyAnnals of Pediatric Endocrinology & Metabolism2287-10122287-12922021-10-0127212112510.6065/apem.2142170.085894Demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes: differences and overlapsTeresa Nieto0Beatriz Castillo1Jacobo Nieto2Maria J. Redondo3 St. Agnes Academy, Houston, TX, USA Baylor College of Medicine, School of Medicine, Houston, TX, USA Rice University, Houston, TX, USA Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USAPurpose Type 1 diabetes (T1D) is the most common type of diabetes in children, but the frequency of type 2 diabetes (T2D) is increasing rapidly. Classification of diabetes is based on a constellation of features that vary by type. We aimed to compare demographic, clinical, and laboratory characteristics at diagnosis of pediatric T1D and T2D. Methods We studied children who visited a large academic hospital in Houston, Texas (USA) with a new diagnosis of T2D (n=753) or T1D (n=758). We compared age, sex, race/ethnicity, presence of obesity, glucose, hemoglobin A1c, islet autoantibody positivity, C-peptide, and presence of diabetic ketoacidosis (DKA) at diabetes diagnosis. Results At diagnosis, children with T2D, compared with those with T1D, were older (13.6 years vs. 9.7 years), more likely female (63.2% vs. 47.8%), of racial/ethnic minority (91.1% vs. 42.3%), and obese (90.9% vs. 19.4%) and were less likely to have DKA (7.8% vs. 35.0%) and diabetes autoantibodies (5.5% vs. 95.4%). Children with T2D also had significantly lower glucose, lower hemoglobin A1c and lower C-peptide level (all comparisons, P<0.0001). In multiple logistic regression analysis, older age, racial/ethnic minority, obesity, higher C-peptide, and negative islet autoantibodies were independently associated with T2D (all, P<0.05), while sex, glucose, hemoglobin A1c, and DKA were not (model P<0.0001). Conclusions There are important demographic, clinical, and laboratory differences between T1D and T2D in children. However, none of the characteristics were unique to either diabetes type, which poses challenges to diabetes classification at diagnosis.http://e-apem.org/upload/pdf/apem-2142170-085.pdftype 1 diabetestype 2 diabetespediatricdiagnosisoverlapclassificationautoimmunitymetabolicdemographicheterogeneity |
| spellingShingle | Teresa Nieto Beatriz Castillo Jacobo Nieto Maria J. Redondo Demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes: differences and overlaps Annals of Pediatric Endocrinology & Metabolism type 1 diabetes type 2 diabetes pediatric diagnosis overlap classification autoimmunity metabolic demographic heterogeneity |
| title | Demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes: differences and overlaps |
| title_full | Demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes: differences and overlaps |
| title_fullStr | Demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes: differences and overlaps |
| title_full_unstemmed | Demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes: differences and overlaps |
| title_short | Demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes: differences and overlaps |
| title_sort | demographic and diagnostic markers in new onset pediatric type 1 and type 2 diabetes differences and overlaps |
| topic | type 1 diabetes type 2 diabetes pediatric diagnosis overlap classification autoimmunity metabolic demographic heterogeneity |
| url | http://e-apem.org/upload/pdf/apem-2142170-085.pdf |
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