Home > Review Articles > The incidence, clinical features, and treatment of type 2 diabetes in children <15 yr in a population-based cohort from Auckland, New Zealand, 1995–2007

The incidence, clinical features, and treatment of type 2 diabetes in children <15 yr in a population-based cohort from Auckland, New Zealand, 1995–2007

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Authors:
Summary:

Data were retrospectively analysed from 52 patients with type 2 diabetes mellitus (T2DM) from a population-based treatment referral cohort, from 1 January 1995 to 31 December 2007. Over this time, the annual incidence of new cases of T2DM in children <15 years increased 5-fold in the Auckland region (from 0.5/100,000 in 1995 to 2.5/100,000 in 2007). The average annual incidence per 100,000 over the entire period was 1.3 overall, 0.1 in Europeans, and 3.4 in both Māori and Pacifica. Fifty-seven percent of children were symptomatic at presentation. Fifty-eight percent of patients were treated with insulin from diagnosis, most of whom were symptomatic. Follow-up data were available for 48 patients with a mean of 2.4 yr. Although insulin therapy was associated with a greater fall in HbA1c values in the first 12 months of treatment (to a nadir of 7.1 vs 8.1%; p<0.05), there was a rapid deterioration after 12 months, and subsequent mean HbA1c values were >9% in both groups.

Comment:
Major messages here to those working in primary care about type 2 DM in under 15-year-olds – the incidence has increased five-fold in the past decade; children are symptomatic but diagnosis is late; and it is poorly managed. Appropriate investigation is required in suspect cases or we may need to consider some form of screening programme.
Reference: Pediatr Diabetes. 2012 May 31. doi: 10.1111/j.1399-5448.2012.00851.x. [Epub ahead of print]
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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