Francine Ratner Kaufman, M.D. Distinguished Professor of Pediatrics The Keck School of Medicine of USC Head, Center for Diabetes and Endocrinology Childrens Hospital Los Angeles Type 2 Diabetes in Youth
Question What Do We Know About Type 2 Diabetes in Youth?
Prevalence of Diabetes and IFG in US Adolescents – NHANES 1999-2002
Type 2 Diabetes
0.5% of adolescents have diabetes
71% type 1 and 29% type 2
Determined by insulin use vs no insulin use
39,005 US teens with T2D
Impaired Fasting Glucose
11% had IFG
2,769,736 teens with IFG
Diabetes Increased 41% from 4.9 to 6.9/1000 from 1997 to 2003 - adults
Duncan, Arch Pediatr Adolesc Med 2006;160:523; Geiss, Am J Prevent Med 2006;30:371
Question What distinguishes type 1 from type 2 diabetes in youth?
Type 1 Versus type 2 Diabetes in youth? Kaufman, Endocrinol Meta Clinics N Am, 34;659-676: 2005 Antibody Ethnicity C-peptide Comorbid Relative with DM DKA Course Weight 15% (reported as high as 30%) NA, AA, HA, Asian, Pacific Islander 85% Whites predominate Normal or increased C-peptide can be preserved at DX Increase in polycystic ovary syndrome Acanthosis nigricans Thyroid, adrenal, vitiligo, celiac 74%-100% - 1 st –2 nd degree with T2DM 5% with T1DM Up to 30% may have with T2DM FH of T2 2-3Xs in person with T1 Ketonuria (33%) Mild DKA (5%-25%) 35%-40% Indolent Virtually none found on screening Rapid From DPT-1 can be indolent Virtually all BMI > 85%th percentile 20% may be overweight / obese T2DM T1DM