Children and adolescents with type 1 and type 2 diabetes mellitus in the Pediatric Diabetes Consortium Registries: comparing clinical characteristics and glycaemic control

Diabet Med. 2020 May;37(5):863-867. doi: 10.1111/dme.14233. Epub 2020 Feb 5.

Abstract

Aim: To compare the characteristics of children and adolescents with type 1 vs. type 2 diabetes in the Pediatric Diabetes Consortium (PDC) registries.

Methods: Participants were 10 to < 21 years of age at diagnosis; there were 484 with type 1 diabetes and 1236 with type 2 diabetes.

Results: Children and adolescents with type 2 diabetes were more likely to be female, overweight/obese, and from low-income, minority ethnic families. Children and adolescents with type 1 diabetes were more likely to present with diabetic ketoacidosis and have higher mean HbA1c levels at diagnosis. More than 70% in both cohorts achieved target HbA1c levels < 58 mmol/mol (< 7.5%) within 6 months, but fewer participants with type 1 than type 2 diabetes were able to maintain target HbA1c levels after 6 months consistently throughout 3 years post diagnosis. Of the 401 participants with type 2 diabetes with ≥ 24 months diabetes duration on enrolment in the registry, 47% required no insulin treatment. Median C-peptide levels were 1.43 mmol/l in the subset of participants with type 2 diabetes in whom it was measured, but only 0.06 mmol/l in the subset with type 1 diabetes.

Conclusions: Although families of children and adolescents with type 2 diabetes face greater socio-economic obstacles and risk factors for poor diabetes outcomes, the greater retention of residual endogenous insulin secretion likely contributes to the increased ability of children and adolescents with type 2 diabetes to maintain target HbA1c during the first 3 years of diabetes diagnosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • C-Peptide / blood
  • Child
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / ethnology
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetic Ketoacidosis / epidemiology*
  • Ethnicity / statistics & numerical data*
  • Female
  • Glycated Hemoglobin / metabolism
  • Glycemic Control
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Minority Groups / statistics & numerical data*
  • Obesity / epidemiology*
  • Overweight / epidemiology
  • Poverty
  • Registries
  • Sex Distribution
  • Treatment Outcome
  • Young Adult

Substances

  • C-Peptide
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • hemoglobin A1c protein, human