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Type 2 Diabetes Mellitus in Children

Journal of the Korean Pediatric Society 2002;45(5):646-653.
Published online May 15, 2002.
Type 2 Diabetes Mellitus in Children
Jee Min Park, Eun Gyong Yoo, Duk Hee Kim
Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
소아연령에서의 2형 당뇨병의 임상적 고찰
박지민, 유은경, 김덕희
연세대학교 의과대학 소아과학교실
Correspondence: 
Duk Hee Kim, Email: dhkim3@yumc.yonsei.ac.kr
Abstract
Purpose
: The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus.
Methods
: We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings.
Results
: Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was 12.9?.8 years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group.
Conclusion
: The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.
Key Words: Type 2 Diabetes mellitus, Obesity, Intrauterine growth retardation


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