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An observational study of type 2 diabetes within a large Australian tertiary hospital pediatric diabetes service
Author(s) -
Ruhayel Sandra D,
James Rebecca A,
Ehtisham Sarah,
Cameron Fergus J,
Werther George A,
Sabin Matthew A
Publication year - 2010
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2010.00647.x
Subject(s) - medicine , diabetes mellitus , body mass index , microalbuminuria , type 2 diabetes mellitus , population , type 1 diabetes , observational study , pediatrics , endocrinology , environmental health
Ruhayel SD, James RA, Ehtisham S, Cameron FJ, Werther GA, Sabin MA. An observational study of type 2 diabetes within a large Australian tertiary hospital pediatric diabetes service. Background: Type 2 diabetes mellitus (T2DM) is emerging as a significant clinical problem within the pediatric population. Objective: The objective of this study was to identify patients with T2DM in a large tertiary hospital diabetes service and examine aspects relating to clinical course and management. Methods: An initial audit of our diabetes service (over 6 yr) was followed by a 2‐yr period of prospective case ascertainment to identify patients with T2DM. Comprehensive data collection was then undertaken in these individuals. Results: Within our service (n = 1574), 33 young people with T2DM were identified. Significant levels of co‐morbidity were evident – dyslipidaemia (56%), microalbuminuria (45%), hypertension (30%) and abnormal retinal findings (25%). Hypertension was more likely in those with greater initial and follow‐up body mass index (BMI) [mean (SD) BMI: 36.3 (5.0) vs. 28.0 (6.3) kg/m 2 , p = 0.001, and 36.8 (5.3) vs. 28.5 (7.8) kg/m 2 , p = 0.007, respectively] and BMI standard deviation score (SDS) [mean (SD) BMI SDS: 2.34 (0.30) vs. 1.72 (0.66), p = 0.001, and 2.26 (0.31) vs. 1.38 (0.87), p < 0.001, respectively], whereas abnormal retinal findings were seen in those with higher HbA1c values at last appointment [geometric mean (range) 10.9 (8.4–13.6) vs. 7.4 (5.6–12.5)%, p = 0.01) and those with greater increases in HbA1c over time (+4.1 (3.1) vs. +0.2 (1.9)%, p = 0.009). Of the 33,9 (27%) were lost to follow‐up. Conclusions: At present, T2DM in youth remains a low burden on our services. Patients with this diagnosis, however, have significant problems that present a major challenge to the development of effective management strategies.