ESPEYB19 12. Type 2 Diabetes, Metabolic Syndrome and Lipids New data on the epidemiology of T2DM in children (2 abstracts)
12.2. Type 2 diabetes in prepubertal children
Astudillo M , Tosur M , Castillo B , Rafaey A , Siller AF , Nieto J , Sisley S , McKay S , Nella AA , Balasubramanyam A , Bacha F & Redondo MJ
Pediatric diabetes 2021;22(7):946-50. doi: 10.1111/pedi.13254
Brief Summary: This retrospective study describes the characteristics of 35 prepubertal children diagnosed with T2DM during 2016–2019 in Houston, Texas. These children had severe obesity, insulin resistance and dyslipidemia.
Comment: We were all appalled when the first incidence of T2DM in a 5-year-old girl was reported in 2014.1 However, the situation is even more serious than it appeared then. This is the first report to focus on prepubertal children with T2DM; the mean age was 10.6±2.5 years. These children had severe obesity, acanthosis nigricans and hyperinsulinemia. At presentation, 20% had NAFLD, 14% had hypertension and 5% microalbuminuria. They accounted for 10% of pediatric patients diagnosed with T2DM in a diabetes clinic in Texas. Such early-onset of T2DM is a huge concern, in view of the accelerated development of microvascular morbidity.
One-third of the patients were younger than ten years old! The authors point out that the findings may change the recommendation of the American Diabetes Association (ADA) to screen for T2DM only in children with obesity and other high-risk factors after the onset of puberty or age >10 years, whichever occurs earlier. Furthermore, as treatment with liraglutide, dulaglutide and exenatide have been approved for ages 10 years and older, drug companies should examine the possibility of extending the indications to younger ages.
Reference: 1. Kevat D, Wilson D, Sinha A. A 5-year-old girl with type 2 diabetes. Lancet. 2014 Apr 5;383(9924):1268. doi: 10.1016/S0140-6736(14)60487-6. PMID: 24703566.
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ESPE Yearbook of Paediatric Endocrinology
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