Clinical presentation of type 2 diabetes mellitus in children and adolescents.
OBJECTIVE
Recent reports indicate an increasing prevalence of type 2 diabetes mellitus (TD2M) in children and adolescents around the world in all ethnicities, possibly due to increasing prevalence of obesity. Therefore, it is essential that clinicians are aware of the clinical features of T2DM in these age groups.


METHODS
All published cases of T2DM in children and adolescents were evaluated and the different clinical presentations of T2DM in minorities and Caucasian described.


RESULTS
Manifestation of T2DM is usually at mid-to-late puberty with few symptoms such as mild-polyuria or polydipsia. Most of the children and adolescents are extremely obese. The great majority of children and adolescents with T2DM have relatives with T2DM, and show other clinical features of the insulin resistance syndrome such as hypertension, dyslipidemia, polycystic ovarian syndrome (PCOS) or acanthosis nigricans. One-third of the minority children with T2DM and the majority of the Caucasian children with T2DM were detected by screening in the absence of symptoms.


CONCLUSIONS
It is becoming increasingly clear that overweight children above the age of 10 y with (1) clinical signs of insulin resistance (acanthosis nigricans, dyslipidemia, hypertension, PCOS), or (2) relatives with T2DM, or (3) of particular ethnic populations (Asian, Indians, Africa-Americans, Hispanics), or (4) extremely obese children should be screened for T2DM.
Reinehr
T
T
Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Datteln, Germany. t.reinehr@kinderklinik-datteln.de
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D003937:Diagnosis, Differential; D005006:Ethnicity; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood / Q000208:ethnology; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D008055:Lipids; D014280:Triglycerides