Obesity at the onset of diabetes in an ethnically diverse population of children: what does it mean for epidemiologists and clinicians?

Abstract:

OBJECTIVE:It is often difficult to determine the pathophysiology of childhood diabetes at onset, particularly in overweight children, because obesity has been associated with both type 1 and type 2 diabetes. We compared children at the diagnosis of diabetes in a multiethnic population-based registry to understand the epidemiology of the disease during a time of rapidly changing diagnostic and treatment norms. METHODS:Incident diabetes was ascertained in Chicagoans who were aged 0 to 17 years from 1985 to 2001. We classified as type 2 those with polycystic ovary syndrome, acanthosis, or a physician's note indicating type 2 or those who reported subsequent use of oral agents (n = 203); 73% of them were also obese. Patients with obesity at onset but no other indicator of possible type 2 (n = 197) were classified as having obesity-related/undetermined type. The remaining 842 cases were classified as type 1. Logistic regression analyses were conducted. RESULTS:Fully 32% of cases were classified as non-type 1, including 37% of non-Hispanic blacks, 30% of Latinos, and 14% of non-Hispanic whites. The proportion of obesity-undetermined and type 2 increased over the 17 years. Comparing the 3 patient groups, type 2 cases were more often female, non-Hispanic black, and older and had a first-degree diabetic relative, whereas Latino boys were overrepresented among the obese/undetermined. CONCLUSION:Obesity is prevalent in youths with newly diagnosed diabetes, particularly during recent years. The growth in non-type 1 diabetes in children since 1985 likely reflects both a true increase and greater physician awareness of the possibility that type 2 diabetes may occur in children.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Lipton RB,Drum M,Burnet D,Rich B,Cooper A,Baumann E,Hagopian W

doi

10.1542/peds.2004-1448

subject

Has Abstract

pub_date

2005-05-01 00:00:00

pages

e553-60

issue

5

eissn

0031-4005

issn

1098-4275

pii

115/5/e553

journal_volume

115

pub_type

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