title: National surveillance for type 2 diabetes mellitus in Taiwanese children.
abstract: 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.
authors.affiliation: Institutes of Environmental Health, National Taiwan University College of Public Health, Taipei.
authors.forename: Jung-Nan
authors.initials: JN
authors.lastname: Wei
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Chau-Ching
authors.initials: CC
authors.lastname: Lin
authors.forename: Ruey-Shiung
authors.initials: RS
authors.lastname: Lin
authors.forename: Chuan-Chi
authors.initials: CC
authors.lastname: Chiang
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
mesh_terms: 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