An observational study of type 2 diabetes within a large Australian tertiary hospital pediatric diabetes service

Authors

  • Sandra D Ruhayel,

    1. Department of Endocrinology and Diabetes at the Royal Children's Hospital and Centre for Hormone Research at the Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia
    Search for more papers by this author
  • Rebecca A James,

    1. University of Melbourne, Melbourne, Victoria 3010, Australia
    Search for more papers by this author
  • Sarah Ehtisham,

    1. University of Melbourne, Melbourne, Victoria 3010, Australia
    Search for more papers by this author
  • Fergus J Cameron,

    1. Department of Endocrinology and Diabetes at the Royal Children's Hospital and Centre for Hormone Research at the Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia
    2. University of Melbourne, Melbourne, Victoria 3010, Australia
    Search for more papers by this author
  • George A Werther,

    1. Department of Endocrinology and Diabetes at the Royal Children's Hospital and Centre for Hormone Research at the Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia
    2. University of Melbourne, Melbourne, Victoria 3010, Australia
    Search for more papers by this author
  • Matthew A Sabin

    Corresponding author
    1. Department of Endocrinology and Diabetes at the Royal Children's Hospital and Centre for Hormone Research at the Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia
    2. University of Melbourne, Melbourne, Victoria 3010, Australia
      Dr Matthew A Sabin, Department of Endocrinology and Diabetes, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
      Tel: (61) 3 9345 5951;
      fax: (61) 3 9347 7763;
      e-mail: matt.sabin@rch.org.au
    Search for more papers by this author

Dr Matthew A Sabin, Department of Endocrinology and Diabetes, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
Tel: (61) 3 9345 5951;
fax: (61) 3 9347 7763;
e-mail: matt.sabin@rch.org.au

Abstract

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/m2, p = 0.001, and 36.8 (5.3) vs. 28.5 (7.8) kg/m2, 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.

Ancillary