Increasing Prevalence of Type 2 Diabetes Mellitus in Thai Children and Adolescents Associated with Increasing Prevalence of Obesity

Likitmaskul, Supawadee; Kiattisathavee, P; Chaichanwatanakul, Katharee; Punnakanta, L; Angsusingha, K; Tuchinda, C

doi:10.1515/jpem.2003.16.1.71

Cited by 96 publications

(57 citation statements)

References 5 publications

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“…The patients with type 1 diabetes attended 3,109 assessments (median 2 assessments per patient, range [1][2][3][4][5][6][7][8][9][10][11][12]. Of the patients with type 2 diabetes, 36 had complications assessment (median 2, range 1-4), all had measurement of AER, 25 had gradable retinal photographs, 24 had peripheral nerve function testing, and 23 had autonomic nerve function testing.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…A population-based incidence estimate from Western Australia demonstrated a 27% increase over 12 years from the early 1990s (5), and data from New South Wales indicate that ϳ1 in 10 adolescents with new-onset diabetes has type 2 diabetes (6). The majority of recent studies of youth-onset type 2 diabetes have addressed its epidemiology and etiology, and a strong association with the increase in childhood obesity is now widely recognized (3,7); however, few studies have addressed the prevalence and risk factors for microvascular complications in this age-group (8 -11).…”

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confidence: 99%

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Prevalence of Diabetes Complications in Adolescents With Type 2 Compared With Type 1 Diabetes

et al. 2006

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OBJECTIVE -To compare the prevalence of diabetes complications and their risk factors in youth with type 1 versus type 2 diabetes.RESEARCH DESIGN AND METHODS -We performed a comparative clinic-based study of 1,433 patients with type 1 diabetes and 68 patients with type 2 diabetes aged Ͻ18 years from New South Wales, Australia. Retinopathy was assessed by seven-field stereoscopic retinal photography; albumin excretion rate from three consecutive, timed, overnight urine collections; peripheral neuropathy by thermal and vibration threshold; and autonomic neuropathy by pupillometry. HbA 1c (A1C) and lipids were measured in all patients and C-peptide in patients with type 2 diabetes.RESULTS -In patients with type 1 versus type 2 diabetes, median (interquartile range) age was 15.7 years (13.9 -17.0) and 15.3 years (13.6 -16.4), respectively (P ϭ 0.2), whereas median diabetes duration was 6.8 years (4.7-9.6) and 1.3 years (0.6 -3.1), respectively (P Ͻ 0.0001). Retinopathy was significantly more common in patients with type 1 diabetes (20 vs. 4%, P ϭ 0.04), while microalbuminuria and hypertension were significantly less common (6 and 16% in type 1 diabetes vs. 28 and 36% in type 2 diabetes). Rates of peripheral and autonomic neuropathy were similar (27 and 61% in type 1 diabetes vs. 21 and 57% in type 2 diabetes). In multivariate analyses, microalbuminuria was significantly associated with older age (odds ratio 1.3 [95% CI 1.2-1.5], P Ͻ 0.001) and systolic hypertension (3.63 [2.0 -6.3], P Ͻ 0.001) in type 1 diabetes, while only higher A1C (1.7 [1.3-2.9], P ϭ 0.002) was significant in patients with type 2 diabetes.CONCLUSIONS -Youth with type 2 diabetes have significantly higher rates of microalbuminuria and hypertension than their peers with type 1 diabetes, despite shorter diabetes duration and lower A1C. The results of this study support recommendations for early complications screening and aggressive targeting of glycemic control in patients with type 2 diabetes. Diabetes Care

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Section: Patient Characteristicsmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence of Diabetes Complications in Adolescents With Type 2 Compared With Type 1 Diabetes

et al. 2006

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“…They reveal type 2 diabetes occurring in children as young as 8 years old (11). In addition, they have demonstrated a female preponderance (22)(23)(24), a strong family history of diabetes (22,25,26), and associations with obesity (11,22,(25)(26)(27), acanthosis nigricans (11,26,27), and polycystic ovary syndrome (PCOS) (28).…”

Section: Population-based Studiesmentioning

confidence: 99%

“…In Mexican-American youth aged 0 -17 years, a California clinic reported that 31% of the diabetic children had type 2 diabetes (32). Among newly diagnosed diabetic children and adolescents in Bangkok, type 2 diabetes increased from 5% of all cases during 1986 -1995 to 17.9% during 1996 -1999 (27). In contrast, among European populations, which have lower overall prevalences of type 2 diabetes, two very large studies have reported that only 0.5% of children and adolescents with diabetes have been classified as having type 2 diabetes (33,34).…”

Section: Population-based Studiesmentioning

confidence: 99%

Type 2 Diabetes in the Young: The Evolving Epidemic

Alberti

Zimmet

Shaw³

et al. 2004

Diabetes Care

412

251

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“…A national survey in 2011 reported a prevalence of 7.6% overweight and 9% obesity among Thai children [10]. Many reports from various countries show increasing numbers and proportion of T2DM in the pediatric population, along with increasing childhood obesity [4,11,12].…”

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confidence: 99%

Original article. Trends and characteristics of childhood diabetes in a tertiary care center in Thailand

et al. 2014

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Background: Reports on characteristics of pediatric diabetes in children from Southeast Asian countries are limited. Objectives: To describe the clinical characteristics, prevalence, glycemic control, and current treatment regimens of diabetes in Thai children. Materials and Methods: Data from 132 patients seen at our pediatric diabetes clinic at Chulalongkorn University during 2001−2013 were retrospectively reviewed. Results:We found an increasing number of patients newly-diagnosed with type 1-(T1DM) or type 2-diabetes mellitus (T2DM). The overall proportion of T1DM was 69.7%, T2DM 23.4%, and other types 6.9%. Children with T1DM were younger at diagnosis, had higher initial glucose and glycated hemoglobin A 1c (HbA 1c ), a lower body mass index z-score, lower C-peptide and insulin levels, and were more likely to have classic diabetes symptoms and ketoacidosis, compared with children with T2DM. Mixed diabetes phenotypes were found in about 12%−14% of these children. Glutamic acid decarboxylase and islet antigen-2 autoantibodies were found in 70% and 54% of T1DM patients, respectively, and not in T2DM patients. HbA 1c in T1DM was 9.6 ± 2.2% total hemoglobin, and in T2DM was 7.9 ± 2.6%. There were no differences in HbA1c levels between different insulin regimens in the T1DM group. Conclusion: The number of children with T1DM or T2DM has been increasing and there are overlapping phenotypes in a significant proportion of these children. Correct diagnosis requires clinical evaluation and monitoring of the clinical course. Further research is needed to determine the risk factors for the poor glycemic control found in children with T1DM.

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Increasing Prevalence of Type 2 Diabetes Mellitus in Thai Children and Adolescents Associated with Increasing Prevalence of Obesity

Cited by 96 publications

References 5 publications

Prevalence of Diabetes Complications in Adolescents With Type 2 Compared With Type 1 Diabetes

Prevalence of Diabetes Complications in Adolescents With Type 2 Compared With Type 1 Diabetes

Type 2 Diabetes in the Young: The Evolving Epidemic

Original article. Trends and characteristics of childhood diabetes in a tertiary care center in Thailand

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