Clinical characteristics of non-obese children with type 2 diabetes mellitus without involvement of β-cell autoimmunity

Urakami, Tatsuhiko; Kuwabara, Remi; Habu, Masako; Okuno, Misako; Suzuki, Junichi; Takahashi, Shori; Mugishima, Hideo

doi:10.1016/j.diabres.2012.11.021

Cited by 16 publications

(27 citation statements)

References 36 publications

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“…However, this is not true in Asia. In Japan, 15% of children with T2D are not obese . In Asian Indian urban children, half of those with T2D had normal weight (<120% ideal for height) , and half of Taiwanese children with T2D were not obese . Youth‐onset T2D has a sex ratio (male:female) that varies from 1:4–1:6 in native North Americans to 1:1 in Asians and Libyan Arabs. In the USA and Europe, youth‐onset T2D is predominately found in populations characterized by low socioeconomic and educational status , whereas in emerging countries like China and India, more affluent children are more likely to develop T2D than poorer children. The presentation of youth‐onset T2D can vary from asymptomatic hyperglycemia detected through screening or during routine physical examination to ketoacidosis in up to 25% of patients or hyperglycemic hyperosmolar state .…”

Section: Definition Classification and Characteristics Of Youth‐onsmentioning

confidence: 99%

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Type 2 diabetes in the child and adolescent

et al. 2014

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Section: Definition Classification and Characteristics Of Youth‐onsmentioning

confidence: 99%

“…However, this is not true in Asia. In Japan, 15% of children with T2D are not obese (17,37). In Asian Indian urban children, half of those with T2D had normal weight (<120% ideal for height) (12), and half of Taiwanese children with T2D were not obese (11).…”

Section: Characteristics Of Individuals With Youth-onset T2dmentioning

confidence: 99%

Type 2 diabetes in the child and adolescent

et al. 2014

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“…We did not analyze the data regarding birth weight in patients diagnosed with type 2 diabetes by the screening program during 2009–2015. Besides, the data from 1975 to 2008 was analyzed, and we found a significant high frequency of small for gestational age (SGA) in non-obese patients [ 14 ]. The mean birth weight of the nonobese patients was not different from that of obese-patients (2,865±480 g vs. 3,002±250 g).…”

Section: Clinical Characteristics In Japanese Children With Nonobese mentioning

confidence: 99%

“…The data from 1974 to 2008 also showed comparison of laboratory data at the time of diagnosis between nonobese patients and obese-patients as indicated Table 1 and Fig. 3 [ 14 ]. There was no significant difference in the mean levels of fasting plasma glucose and glycosylated hemoglobin, expressed as the National Standardization Program value, between the two groups.…”

Section: Clinical Characteristics In Japanese Children With Nonobese mentioning

confidence: 99%

“…Particularly, patients with nonobese type 2 diabetes tend to progress earlier to pharmacological treatment using oral hypoglycemic agents (OHA) or insulin. We found over 95% of patients with nonobese type 2 diabetes eventually progressed to pharmacological treatment: i.e., 45.8% treated with OHA and 50.0 % with insulin [ 14 ]. The mean interval to start of pharmacological treatment was 3.1±2.3 years (2.2±2.1 years for OHD and 4.8±2.9 years for insulin).…”

Section: Clinical Characteristics In Japanese Children With Nonobese mentioning

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Clinical characteristics in Japanese children with nonobese type 2 diabetes

Urakami

2018

Ann Pediatr Endocrinol Metab

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It is well known that the incidence of youth-onset type 2 diabetes is increasing worldwide. On the other hand, most studies have shown that the majority of youth-onset type 2 diabetes occurs in obese individuals, generally with a body mass index (BMI) greater than the 90th or 95th centile for sex- and age-matched children and adolescents. However, we identified some Japanese children with nonobese type 2 diabetes and BMI less than 90th centile by a urine glucose screening program at schools in the Tokyo Metropolitan Area. According to the results obtained from the screening, clinical characteristics of patients with nonobese type 2 diabetes seemed to be different from those in obese type 2 diabetes. Nonobese patients tended to show lower insulin secretion abilities and milder, but evident, insulin resistance from the time of diagnosis. Female, low birth weight (small for gestational age), and genetic background, not related to β-cell-associated autoimmunity, may play a role in development of nonobese type 2 diabetes. In addition, nonobese patients tend to progress earlier to pharmacological treatment including oral hypoglycemic drugs and insulin. Further studies are needed to confirm to these findings and clarify the pathophysiology of children with nonobese type 2 diabetes.

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The Prevalence of Obesity Among Children With Type 2 Diabetes

et al. 2022

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ImportanceThe childhood obesity epidemic is presumed to drive pediatric type 2 diabetes (T2D); however, the global scale of obesity in children with T2D is unknown.ObjectivesTo evaluate the global prevalence of obesity in pediatric T2D, examine the association of sex and race with obesity risk, and assess the association of obesity with glycemic control and dyslipidemia.Data SourcesMEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science were searched from database inception to June 16, 2022.Study SelectionObservational studies with at least 10 participants reporting the prevalence of obesity in patients with pediatric T2D were included.Data Extraction and SynthesisFollowing the Meta-analysis of Observational Studies in Epidemiology reporting guideline, 2 independent reviewers in teams performed data extraction and risk of bias and level of evidence analyses. The meta-analysis was conducted using a random-effects model.Main Outcomes and MeasuresThe primary outcomes included the pooled prevalence rates of obesity in children with T2D. The secondary outcomes assessed pooled prevalence rates by sex and race and associations between obesity and glycemic control and dyslipidemia.ResultsOf 57 articles included in the systematic review, 53 articles, with 8942 participants, were included in the meta-analysis. The overall prevalence of obesity among pediatric patients with T2D was 75.27% (95% CI, 70.47%-79.78%), and the prevalence of obesity at diabetes diagnosis among 4688 participants was 77.24% (95% CI, 70.55%-83.34%). While male participants had higher odds of obesity than female participants (odds ratio, 2.10; 95% CI, 1.33-3.31), Asian participants had the lowest prevalence of obesity (64.50%; 95% CI, 53.28%-74.99%), and White participants had the highest prevalence of obesity (89.86%; 95% CI, 71.50%-99.74%) compared with other racial groups. High heterogeneity across studies and varying degrees of glycemic control and dyslipidemia were noted.Conclusions and RelevanceThe findings of this systematic review and meta-analysis suggest that obesity is not a universal phenotype in children with T2D. Further studies are needed to consider the role of obesity and other mechanisms in diabetes genesis in this population.

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Clinical characteristics of non-obese children with type 2 diabetes mellitus without involvement of β-cell autoimmunity

Cited by 16 publications

References 36 publications

Type 2 diabetes in the child and adolescent

Type 2 diabetes in the child and adolescent

Clinical characteristics in Japanese children with nonobese type 2 diabetes

The Prevalence of Obesity Among Children With Type 2 Diabetes

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