National surveillance for type 2 diabetes mellitus in Taiwanese children.
BACKGROUND
Despite a disturbing trend of increasing prevalence of type 2 diabetes mellitus (DM) in childhood, little is known about the epidemiology of childhood type 2 DM, especially in the Taiwanese population.


OBJECTIVE
To study the rate and risk factors for childhood type 2 DM based on a nationwide screening program in Taiwan.


METHODS
Screening in 1999 for type 2 DM using urine and blood testing and confirmed by follow-up telephone survey among schoolchildren aged 6 to 18 years in Taiwan, followed by a nested case-control study conducted in 2002 comparing 137 children with type 2 DM with 1,000 randomly selected children without diabetes chosen to represent the age and sex distribution of the whole student population.


METHODS
Rate and identification of risk factors associated with childhood type 2 DM.


RESULTS
The rate of newly identified diabetes was 9.0 per 100,000 for boys and 15.3 per 100,000 for girls. Follow-up at 3 years revealed that, of 253 children with newly diagnosed diabetes, 24 (9.5%) had type 1 DM, 137 (54.2%) had type 2 DM, and 22 (8.7%) had secondary diabetes. Compared with children aged 6 to 9 years, the odds ratios (ORs) and 95% confidence intervals (CIs) of type 2 DM increased to 6.59 (3.23-13.4) for those aged 13 to 15 years and to 4.59 (2.07-10.2) for those aged 16 to 18 years. The OR (95% CI) of type 2 DM in children with a body mass index in the 95th percentile or higher (obesity) was 18.8 (9.22-38.5) compared with those with a body mass index in less than the 50th percentile. Other factors significantly associated with type 2 DM were hypercholesterolemia (OR, 1.80; 95% CI, 1.04-3.23), blood pressure greater than the 85th percentile (OR, 1.70; 95% CI, 1.07-2.70), and positive family history of diabetes (OR, 3.95; 95% CI, 2.01-7.78).


CONCLUSIONS
Our mass screening program showed that type 2 DM is the leading cause of childhood DM in Taiwan. Obesity is a major risk factor for the development of type 2 DM in children.
Wei
Jung-Nan
JN
Institutes of Environmental Health, National Taiwan University College of Public Health, Taipei.
Sung
Fung-Chang
FC
Lin
Chau-Ching
CC
Lin
Ruey-Shiung
RS
Chiang
Chuan-Chi
CC
Chuang
Lee-Ming
LM
D000293:Adolescent; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D009765:Obesity; D011159:Population Surveillance; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology