Type 2 diabetes in Asian-Indian urban children

Abstract

OBJECTIVE - Due to a background of high prevalence of type 2 diabetes and the increasing rate of obesity occurring in relatively young urban children, we felt the need to look for type 2 diabetes in children. RESEARCH DESIGN AND METHODS - A study of cases of type 2 diabetes with age at diagnosis of ≤ 15 years seen at a diabetes speciality center in Chennai, India, is reported. A total of 18 children (5 boys and 13 girls) aged 9-15 years with insidious onset of diabetes responding to oral antidiabetic agents (ODAs) for periods from 2 months to 12 years were studied. Clinical details, anthropometry, and details of family history of diabetes were elicited. All of them were tested for the presence of anti-GAD65 antibodies and for pancreatic β-cell reserve by measuring serum C-peptide response (radioimmunoassay procedures). RESULTS - All children showed a response to ODAs, had good β-cell reserve (≥0.6 pmol/ml on stimulation), and negligible GAD65 antibodies indicating the presence of type 2 diabetes. The children were nonketotic; nine were obese, four had acanthosis nigricans, and one had polycystic ovary syndrome. Positive family history of diabetes was present in all cases. CONCLUSIONS - The clinical, immunological, and biochemical profile showed that the children had type 2 diabetes. The profile of type 2 diabetes was similar to that described in children in many other countries. Although less common than type 1 diabetes, type 2 diabetes in children is a condition that needs to be recognized and looked for in Asian-Indians.