All issues > Volume 43(12); 2000

Original Article

J Korean Pediatr Soc. 2000;43(12):1591-1598. Published online December 15, 2000.

The Clinical Types and Characteristics of Diabetes Mellitus in Korean Children

Eun Gyong EG Yoo¹, Hye Jung HJ Shin¹, Duk Hi DH Kim¹

¹Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea

Abstract

Purpose
: Diabetic children should be classified into type 1 or 2 for adequate diabetic control. However, there is a shortage of information of the appropriate criteria in Korea. This study is desinged to discover the clinical types and characteristics of diabetes mellitus(DM) in Korean children.
Methods
: We studied the clinical characteristics and laboratory findings of 177 diabetic children. Classification was based on the serum C-peptide levels, presence of ketoacidosis, autoantibodies, and insulin dependence.
Results
: Among 177 diabetic children, 147(83.1%) were classified as type 1 and 21(11.9%) as type 2, and 12(57.1%) children in type 2 were obese. All patients with age of onset before 9 were type 1. In cases of type 1, initial serum C-peptide levels were <0.6(50%), 0.6-1.0(44%) and >1.0ng/mL (6%). All patients with initial serum C-peptide level above 1.5ng/mL were type 2. Four patients initially diagnosed as type 2 DM changed to type 1 during follow-up, and 2 patients of type 1 DM changed to type 2. Only 55.4% of type 1 DM patients had insulin autoantibody, islet cell cytoplasmic antibody or anti-glutamic acid decarboxylase antibodies.
Conclusion
: Most diabetic children in Korea were classified as type 1. Our results suggest that insulin requiring lean patients with positive autoantibody should be classified as type 1 even if their serum C-peptide levels are within normal range, and the clinical types could be changed during follow-up in a small proportion of diabetic children.

Keywords :Diabetes mellitus, Classification, Type 1, Type 2, C-peptide