Type 2 diabetes in youth from the Western Pacific region: glycaemic control, diabetes care and complications.
OBJECTIVE
To describe the glycaemic control, diabetes care and prevalence of complications in youth with type 2 diabetes from the Western Pacific Region.


METHODS
Cross-sectional, clinic-based audit of 331 patients aged < 18 years from 56 centres in Australia, China-Beijing, China-Shanghai, China-Hong Kong, Indonesia, Japan, South Korea, Malaysia, Philippines, Singapore, Taiwan and Thailand. Clinical and management data were recorded along with glycated haemoglobin (HbA(1c)), lipids and complication rates.


METHODS
Glycaemic control, complications, diabetes management.


RESULTS
Median age was 14.9 years (interquartile range 13.2-16.4 years) and median diabetes duration 2.3 years (1.4-3.6 years). Median HbA(1c) was 7% (5.9-9.9%) and HbA(1c) was > 7.5% in 40% of patients. In multiple regression analysis, glycaemic control varied significantly between countries (p = 0.02); higher HbA(1c) was associated with fewer home blood glucose measurements (p = 0.005) and higher insulin dose/kg (p < 0.0001). Blood glucose monitoring was performed by 65% of patients (range 33-96% by country). In 25% of patients, management consisted of diet alone or no treatment (range 0-53% by country); oral anti-diabetic drugs alone were used in 49%, insulin alone in 11% and both in 15%. Microalbuminuria was found in 8% and hypertension in 24%. The risk of hypertension increased with higher BMI (OR 1.16, 95% CI 1.09-1.24, p < 0.0001); antihypertensive agents were used in 4% of patients.


CONCLUSIONS
The management of type 2 diabetes in youth from the Western Pacific Region varies widely. Hypertension and microalbuminuria were frequent, but not commonly treated. Further investigation into the natural history and risk factors for complications in youth with type 2 diabetes is required to assist in developing evidence based management guidelines.
Eppens
Maike C
MC
The Children's Hospital at Westmead, Sydney, NSW, Australia.
Craig
Maria E
ME
Jones
Timothy W
TW
Silink
Martin
M
Ong
Stephanie
S
Ping
Yeo Jing
YJ
D000293:Adolescent; D000367:Age Factors; D000419:Albuminuria; D001210:Asia, Southeastern / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006306:Health Surveys; D006801:Humans; D007022:Hypotension; D007564:Japan / Q000453:epidemiology; D007723:Korea / Q000453:epidemiology; D008297:Male; D014904:Western Australia / Q000453:epidemiology
D001786:Blood Glucose; D006442:Glycated Hemoglobin