title: Ethnic Minorities Are at Greater Risk for Childhood-Onset Type 2 Diabetes and Poorer Glycemic Control in England and Wales.
abstract: Ethnic minority children are at a greater risk for type 2 diabetes (T2D). However, current prevalence of T2D among children and young people is unknown in England and Wales. In addition, little is known on glycemic control in pediatric T2D globally.
  
  
  
  Using data from the National Paediatric Diabetes Audit for 2012-2013 with >98% coverage of diabetes cases, we estimated (1) the overall, gender- and ethnic-specific prevalence of T2D in children and young people <16 years and (2) whether ethnicity predicts glycemic control (measured by mean HbA1c) in children and young people <19 years. Ethnicity was self-identified and categorized into white, Asian, black, mixed, other, and "not stated." Multivariable linear regression was used to estimate differences in glycemic control by ethnicity adjusting for socioeconomic status, age, diabetes duration, and gender.
  
  
  
  A total of 307 children and young people aged <16 years were identified with T2D in the National Paediatric Diabetes Audit for 2012-2013. Overall prevalence of T2D was 2.9/100,000. Females had a higher prevalence of T2D than males (4.3 vs. 1.5/100,000). The highest prevalence was found in Asian (12.2/100,000) followed by mixed ethnicity (4.4/100,000) females. Children of mixed ethnicity had significantly higher mean HbA1c compared with white children (9.7% [83 mmol/mol] vs. 7.8% [62 mmol/mol], p < .001, and adjusted mean difference of 4.2% [22.3 mmol/mol], 95% confidence interval = 3.1%-5.2% [10.9-33.7 mmol/mol]), but there were no significant differences between the other ethnic minority groups.
  
  
  
  Children of all ethnic minorities particularly females have an increased prevalence of T2D. Those belonging to mixed ethnic backgrounds are at increased risk for poorer glycemic control.
authors.affiliation: Institute of Child Health, University College London (UCL), London, United Kingdom; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: a.khanolkar@ucl.ac.uk.
authors.forename: Amal R
authors.initials: AR
authors.lastname: Khanolkar
authors.affiliation: Institute of Child Health, University College London (UCL), London, United Kingdom.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Amin
authors.affiliation: Institute of Child Health, University College London (UCL), London, United Kingdom; Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Taylor-Robinson
authors.affiliation: Institute of Child Health, University College London (UCL), London, United Kingdom.
authors.forename: Russell
authors.initials: R
authors.lastname: Viner
authors.affiliation: Department of Child Health, Children's Hospital for Wales, Cardiff, United Kingdom.
authors.forename: Justin
authors.initials: J
authors.lastname: Warner
authors.affiliation: Institute of Child Health, University College London (UCL), London, United Kingdom.
authors.forename: Terence
authors.initials: T
authors.lastname: Stephenson
mesh_terms: D000293:Adolescent; D044466:Asian People / Q000706:statistics & numerical data*; D044383:Black People / Q000706:statistics & numerical data*; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D014852:Wales / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Adolescence; Childhood; England; Ethnicity; Glycemic control; HbA(1c); Prevalence; Type 2 diabetes; Wales