Type 2 Diabetes in Children and Adolescents. Arlan L. Rosenbloom

2 diabetes in children and youth was comparable to that of type 1 diabetes in Caucasians (3)

      

Review of 1,027 consecutive records of children 0–19 years old diagnosed with diabetes in Cincinnati, Ohio found (4)

      

2–4% diagnosed with type 2 diabetes from 1982 to 1992 (stable for over 20 years; Knowles [5] reported that ∼3.5% of patients in this same clinic had type 2 diabetes in 1971)

      

16% diagnosed with type 2 diabetes in 1994

      

33% of newly diagnosed patients age 10–19 years with type 2 diabetes in 1994

Table 9. Estimates of the Frequency of Type 2 Diabetes in Children and Adolescents

      

estimated age-specific incidence to be 7.2 per 100,000,

      

one-half the incidence rate for type 1 diabetes in the childhood population

      

a tenfold increase since 1982

      

Cincinnati (4) and Arkansas (6): African Americans accounted for 70–75% of pediatric type 2 diabetes patients.

      

Mexican Americans (7): One-third of diabetes patients under the age of 17 years have type 2 diabetes.

      

In a study of 682 patients age 5–19 years diagnosed between January 1, 1994, and December 31, 1998, at the three university diabetes centers in Florida (8)

      

86% were considered to have type 1 diabetes and 14% type 2 diabetes

      

47% of patients with type 1 diabetes and 63% of patients with type 2 diabetes were female

      

only 46% of those with type 2 diabetes were African American, 22% were Hispanic, and the rest were non-Hispanic Caucasian

      

the proportion of newly diagnosed patients with diabetes who had type 2 diabetes increased from 8.7% in 1994 to 19% in 1998

      Table 10. Type 2 Diabetes in Children and Adolescents Outside of North America

      

Libyan Arabs (9)

      

Age-specific annual incidence

      

6/100,000 for age 15–19 years

      

26/100,000 for age 20–24 years

      

100/100,000 for age 25–29 years

      

240/100,000 for age 30–34 years

      

Overall (age 0–34)

      

>2 times the incidence of type 1 diabetes in males

      

>4 times the incidence of type 1 diabetes in females

      

Hong Kong Chinese (10)

      

Accounts for >90% of young onset diabetes in Chinese

      

Strongly familial

      

Associated with obesity

      

Taiwan Chinese (11)

      

From 1992 to 1999, annual urine screening of schoolchildren followed by repeat test and fasting blood test for glycemia, as indicated

      

Nearly 3 million students tested each semester

      

Incidence rates

      

8.3 per 100,000 among boys and 12.0 per 100,000 among girls

      

significant increase from 6th grade for boys and 4th grade for girls, with peak rates

       14.7 per 100,000 in 8th grade for boys

       19.0 per 100,000 in 6th grade for girls

      

Japanese (12)

      

Type 1 diabetes relatively rare as in Chinese

      

Annual urine testing of schoolchildren within Tokyo prefecture since 1975, followed by oral glucose tolerance testing as indicated

      

∼4 fold increased incidence of type 2 diabetes between 1976 and 1995

      

increased incidence of type 2 diabetes paralleled by increasing obesity rates

      

Bangladeshi (13)

      

Population sampling of ∼7000 suburban residents including ∼300 age 15–20 years

      

Type 2 diabetes prevalence