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

摘要

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 HbA 1c levels at diagnosis. More than 70% in both cohorts achieved target HbA 1c levels ?58?mmol/mol (?7.5%) within 6 months, but fewer participants with type 1 than type 2 diabetes were able to maintain target HbA 1c 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 HbA 1c during the first 3 years of diabetes diagnosis.