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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Characteristics of type 1 and type 2 diabetes mellitus in children and adolescents

Characteristics of type 1 and type 2 diabetes mellitus in children and adolescents
  Type 1 diabetes Type 2 diabetes
Prevalence Common, increasing Increasing
Age at presentation Throughout childhood Puberty
Onset Typically acute severe Insidious to severe
Ketosis at onset Common 5 to 10%*
Affected relative 5 to 10% 75 to 90%
Female:male 1:1 Approximately 2:1
Inheritance Polygenic Polygenic
HLA-DR3/4 Strong association No association
Ethnicity Most common in non-Hispanic White people All
Insulin secretion Decreased/absent Variable
Insulin sensitivity Normal when controlled Decreased
Insulin dependence Permanent Variable
Obese or overweight 20 to 25% overweightΔ >80% obese
Acanthosis nigricans 12%◊ 50 to 90%◊
Pancreatic antibodies Yes§ No¥
T1DM: type 1 diabetes mellitus; T2DM: type 2 diabetes mellitus; IAA: autoantibodies to insulin; ICA: islet cell cytoplasm; GAD: glutamic acid decarboxylase; IA: tyrosine phosphatase (insulinoma-associated) antibody; ZnT8: zinc channel antibody.
* Reported frequency of ketonuria or ketoacidosis at time of diagnosis of T2DM varies widely.
¶ In North America, T2DM predominates in Native American, African American, Hispanic, Canadian First Nation, Pacific Islander, and Asian American youth[1].
Δ With increased prevalence of childhood overweight, 20 to 25% of newly diagnosed children with T1DM are overweight, which is higher than the prevalence of overweight in a similar population without T1DM. However, the prevalence of obesity is not increased among children and adolescents with T1DM[2,3]. Recent weight loss is common at presentation of children with T1DM, including among those who are overweight or obese.
◊ These frequencies of acanthosis nigricans are based on a registry study in the United States. Populations with lower rates of obesity or different ethnic mixes may have different results[4].
§ IAA, ICA, GAD, IA-2 and IA-2-beta, or ZnT8 are present at diagnosis in 85 to 98% of patients with T1DM[4,5].
¥ One study reported that 9.8% of youth with phenotypic T2DM have pancreatic antibodies to IA-2 and/or GAD[6].
References:
  1. Mayer-Davis EJ, Bell RA, Dabelea D, et al. The many faces of diabetes in American youth: type 1 and type 2 diabetes in five race and ethnic populations: the SEARCH for Diabetes in Youth Study. Diabetes Care 2009; 32 Suppl 2:S99.
  2. Liu LL, Lawrence JM, Davis C, et al. Prevalence of overweight and obesity in youth with diabetes in USA: the SEARCH for Diabetes in Youth study. Pediatr Diabetes 2010; 11:4.
  3. Kaminski BM, Klingensmith GJ, Beck RW, et al. Body mass index at the time of diagnosis of autoimmune type 1 diabetes in children. J Pediatr 2013; 162:736.
  4. Dabelea D, Pihoker C, Talton JW, et al. Etiological approach to characterization of diabetes type: the SEARCH for Diabetes in Youth Study. Diabetes Care 2011; 34:1628.
  5. Steck AK, Johnson K, Barriga KJ. Age of Islet Autoantibody Appearance and Mean Levels of Insulin, but Not GAD or IA-2 Autoantibodies, Predict Age of Diagnosis of Type 1 Diabetes. Diabetes Care 2011; 34:1397.
  6. Klingensmith GJ, et al. The presence of GAD and IA-2 antibodies in youth with a type 2 diabetes phenotype: results from the TODAY study. Diabetes Care 2010; 33:1970.
Modified from: Rosenbloom AL, Joe JR, Young RS, Winter WE. Emerging epidemic of type 2 diabetes in youth. Diabetes care 1999; 22:345-354.
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