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Type 2 diabetes incidence rising among UK girls, South Asian children
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The number of cases of type 2 diabetes among children in the United Kingdom rose during the past decade, with evidence of an increasing trend among girls and children of South Asian ethnicity, according to findings published in Diabetic Medicine.
“Identifying type 2 diabetes in childhood is important so that management can start as early as possible,” Toby Candler, MBBS MRCPCH, a research fellow with the NIHR Biomedical Research Centre at the University of Bristol, United Kingdom, told Endocrine Today. “Type 2 diabetes in young people is an aggressive disease. Those at higher risk of type 2 diabetes are the obese with a first degree, family history of type 2 diabetes, of non-white ethnicity and female. A third of cases were asymptomatic and detected on obesity screening investigations, highlighting the importance of screening for type 2 diabetes in higher risk children.”
Candler and colleagues analyzed cases of type 2 diabetes diagnosed in children between May 2015 and April 2016, using the British Paediatric Surveillance Unit reporting framework, a prospective monthly surveillance of more than 3,400 pediatricians in the U.K. and Ireland. Incidence was defined as the number of new cases per population during 1 year. Researchers used Poisson regression models to compare type 2 diabetes incidence rates in different groups, using Ethnic Group by Age in England and Wales 2011 data. Overall U.K. type 2 diabetes incidences in children for 2015 were compared with corresponding rates for 2005 using incidence rate ratio.
Researchers identified 106 newly confirmed cases between May 2016 and April 2016, with 67% of cases among girls. Median age at diagnosis was 14 years, 44% of children were white and 65% were Asian or of Asian-British descent. Among children diagnosed, 81% had a family history of type 2 diabetes, with a first-degree relative in 70% of cases.
Researchers determined the national U.K. incidence of type 2 diabetes in children was 0.72 per 100,000, based on the estimated U.K. population of 13,008,432 in mid-2015. South Asian children (incidence rate, 2.92 per 100,000) and black children (incidence rate, 1.67 per 100,000) had a higher incidence rate of type 2 diabetes vs. white children (incidence rate, 0.44 per 100,000), according to researchers. Researchers also observed a trend toward increased incidence of type 2 diabetes (incidence rate ratio = 1.35; 95% CI, 0.99-1.84); however, the number did not rise to statistical significance. Researchers observed evidence that incidence increased among girls (P = .03) and South Asian children (P = .01) during the decade.
“It is important to understand why some children with obesity develop type 2 diabetes and others do not,” Candler said. “Developing a better understanding of the pathogenesis of the disease is very important in order to produce strategies for prevention and treatment. It is important to establish the best way to manage and engage young people with type 2 diabetes due to the poor outcomes in those diagnosed at a young age. The results of the 1-year follow up of these cases will bring valuable insights into variables associated with clinical outcomes (eg, HbA1c and associated complications) and may help inform future treatment strategies.” – by Regina Schaffer
For more information:
Toby Candler, MBBS MRCPCH, can be reached at Cambridge Biomedical Research Centre, Box 277, Hills Rd., Cambridge CB2 0QQ; email: toby.candler@gmail.com.
Disclosures: The study was funded by a grant from the National Institute for Health Research Translational Research Collaboration for Rare DiseasesThe authors report no relevant financial disclosures.
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