Incidence and clinical characteristics of pediatric‐onset type 2 diabetes in Hong Kong : The Hong Kong childhood diabetes registry 2008 to 2017

Abstract

Objective: With increasing prevalence of childhood obesity worldwide, the incidence of pediatric-onset type 2 diabetes (T2D) is also increasing in many countries. We aim to analyze the time trend and incidence of T2D in children in Hong Kong from 2008 to 2017, and to characterize clinical characteristics at diagnosis. Methods: Data were retrieved from the Hong Kong Childhood Diabetes Registry. All children with T2D diagnosed at the age of less than 18 years from January 1, 2008 to December 31, 2017 and managed in the public health care system were included in this study.Results: In the incident years of 2008-2017 period, 391 children were diagnosed with T2D. The crude incidence rate was 3.42 per 100,000 persons/year [95% confidence interval (CI) 3.08-3.76], which was much higher than that in last registry of 1.27 per 100,000 persons/year in 1997-2007 (P < 0.001).Most children (76%) were

The Prevalence of Obesity Among Children With Type 2 Diabetes

“…Overall, 26 studies (45.60%) had a cross-sectional design, 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 23 (40.40%) were retrospective cohort studies, 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 and 8 (14.00%) were prospective cohort studies. 3 , 11 , 87 , 88 , 89 , 90 , 91 , 92 eTable 6 in Supplement 1 reports the characteristics of the included studies.…”

“…Of the 57 studies, 12 did not report specific diabetes diagnostic criteria, 43 , 49 , 59 , 64 , 69 , 70 , 72 , 75 , 76 , 78 , 84 , 91 and 18 did not report measuring autoantibodies. 44 , 49 , 58 , 59 , 62 , 65 , 69 , 70 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 83 , 84 , 85 Of the studies reporting autoantibody testing results, 55 patients had positive tests.…”

“…Data from 53 studies with 8942 participants estimated the overall pooled prevalence of obesity in pediatric patients with T2D to be 75.27% (95% CI, 70.47%-79.78%; I 2 = 96%; P < .001) ( Figure 1 and Figure 2 ). 3 , 11 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 Four of the 57 studies were not included in this meta-analysis, with 1 study not providing an exact prevalence estimate, 66 and 3 containing race-based subgroup dat...…”

“…We also excluded studies of patients who presented with weight loss. 3,39,40,43,49,65,67,72,74,80,[82][83][84]86 The pooled obesity prevalence was 72.87% (95% CI, 66.58%-78.75%, I 2 = 97%, P < .001). We also performed a sensitivity analysis removing studies that specifically excluded patients with MODY based on genetic testing results, 3,39,45,51,60,72,80,82,[86][87][88] and the pooled prevalence was 78.87%; (95% CI, 74.70%-82.77%; I 2 = 85%; P < .001).…”

“…60 Region-based analysis revealed that North America had the highest prevalence of obesity in patients with T2D at 81.14% (95% CI, 75.99%-85.83%; I 2 = 94%; P < .001; n = 4779). [39][40][41]43,49,51,57,59,64,65,67,69,71,[79][80][81][82]84,85,90,92 The Middle East had the second highest, at 78.41% (95% CI, 68.29%-87.12%; I 2 = 77%; P < .001; n = 547), 61,62,74,86,91 followed by Oceania at 74.03% (95% CI, 55.52%-89.15%; I 2 = 96%; P < .001; n = 871), 11,46,48,60,68,75,76,89 Asia at 68.54% (95% CI, 61.16%-75.51%; I 2 = 89%; P < .001; n = 1682), 4,38,42,50,55,56,58,63,70,73,83 and Europe at 68.30% (95% CI, 54.84%-80.43%; I 2 = 92%, P < .001, n = 1063) (eFigure 3 in Supplement 1). 3,…”