Clinical characteristics of type 2 diabetes mellitus in overweight European caucasian adolescents.
OBJECTIVE
To present the clinical features of Type 2 diabetes mellitus (T2DM) in overweight European Caucasian children and adolescents.


METHODS
We report the clinical characteristics of 16 non-syndromal overweight European Caucasian adolescents with T2DM (10 boys, 6 girls, SDS-BMI in median +2.8, range +1.6 to +3.4) treated in 5 specialised centres for obesity and diabetes.


RESULTS
None of the adolescents manifested with ketoacidosis. 13 were asymptomatic (3 adolescents with polyuria), 12 showed features of metabolic syndrome (dyslipidaemia or hypertension), 8 demonstrated acanthosis nigricans and 12 had relatives with T2DM. 11 adolescents were extremely obese and all patients were pubertal. Mean age at diagnosis was 14.2 years (range 11.0 - 16.9). Median insulin was 19 microU/ml, insulin resistance index (HOMA) 8.5, C-peptide 2.3 ng/ml, HbA1c 6.9 %, fasting blood glucose 176 mg/dl and blood glucose at 2 hours with the oGTT 229 mg/dl at manifestation. Fasting blood glucose and HBA1c were in the normal range in 4 and 6 adolescents respectively, while oGTT always fitted the diagnosis of T2DM.


CONCLUSIONS
Since T2DM occurred in Caucasian overweight adolescents and is frequently asymptomatic, it is essential that clinicians perform diagnostic procedures to identify T2DM in high-risk groups of overweight Caucasian adolescents (extreme obesity, features of metabolic syndrome, relatives with T2DM).
Reinehr
T
T
Vestische Kinder- und Jugendklinik, University of Witten-Herdecke, Datteln, Germany. T.Renehr@kinderklinik-datteln.de
Andler
W
W
Kapellen
T
T
Kiess
W
W
Richter-Unruh
A
A
Schönau
E
E
Seewi
O
O
Heinze
E
E
Wabitsch
M
M
D000052:Acanthosis Nigricans / Q000209:etiology; D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology*; D005060:Europe; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006949:Hyperlipidemias / Q000209:etiology; D006973:Hypertension / Q000209:etiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology; D009765:Obesity / Q000150:complications* / Q000178:diet therapy / Q000208:ethnology*; D011141:Polyuria / Q000209:etiology; D011627:Puberty; D044465:White People
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin