Prevalence and clinical features of type 1.5 diabetes mellitus in children.
OBJECTIVE
To classify children with diabetes mellitus as type 1, 1.5 or 2, based on strict criteria, and then compare their features and treatment.


METHODS
In this retrospective study, all children with diabetes mellitus in our clinic with antibody status available (n = 120) were reclassified as type 1, 1.5 or type 2 based on status of antibodies to the pancreas and presence of obesity and/or acanthosis nigricans, and their features compared.


RESULTS
Sixty-four percent of type 2 patients were reclassified as type 1.5. Type 1.5 patients had significantly lower BMI SDS, blood pressure and acanthosis nigricans than type 2 patients. They had a higher insulin requirement (0.82 +/- 0.44 U/kg/day) than type 1 (0.72 +/- 0.35 U/kg/day) or type 2 (0.28 +/- 0.3 U/kg/day) patients. Total cholesterol, HDL-cholesterol, ALT and AST significantly worsened from type 1 to 1.5 to type 2 patients.


CONCLUSIONS
Type 1.5 diabetes mellitus should be considered among obese adolescents presenting as type 2, as their clinical course is more aggressive and insulin requirement higher.
Department of Pediatric Endocrinology, Infant's and Children's Hospital at Maimonides, Brooklyn, NY 11291, USA. drpradhika@hotmail.com
Radhika
R
Purushothaman
Neesha
N
Ramchandani
Irina
I
Kazachkova
Svetlana
S
Ten
D000052:Acanthosis Nigricans / Q000150:complications; D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000145:classification* / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies
D001323:Autoantibodies; D006442:Glycated Hemoglobin; D007328:Insulin