title: Clinical and Metabolic Characteristics among Mexican Children with Different Types of Diabetes Mellitus.
abstract: BACKGROUND
  Current classification of diabetes mellitus (DM) is based on etiology and includes type 1 (T1DM), type 2 (T2DM), gestational, and other. Clinical and pathophysiological characteristics of T1DM and T2DM in the same patient have been designated as type 1.5 DM (T1.5DM).
  
  
  OBJECTIVE
  The aim of this study was to classify pediatric patients with DM based on pancreatic autoimmunity and the presence or absence of overweight/obesity, and to compare the clinical, anthropometric, and biochemical characteristics between children in the different classes of DM.
  
  
  METHODS
  A sample of 185 patients, recruited (March 2008-April 2015) as part of the Cohort of Mexican Children with DM (CMC-DM); ClinicalTrials.gov, identifier: NCT02722655. The DM classification was made considering pancreatic autoimmunity (via antibodies GAD-65, IAA, and AICA) and the presence or absence of overweight/obesity. Clinical, anthropometric and biochemical variables, grouped by type of DM were compared (Kruskal-Wallis or chi-squared test).
  
  
  RESULTS
  The final analysis included 140 children; 18.57% T1ADM, 46.43% T1BDM, 12.14% T1.5DM, and 22.86% T2DM. Fasting C-Peptide (FCP), and hs-CRP levels were higher in T1.5DM and T2DM, and the greatest levels were observed in T1.5DM (p<0.001 and 0.024 respectively).
  
  
  CONCLUSIONS
  We clearly identified that the etiologic mechanisms of T1DM and T2DM are not mutually exclusive, and we detailed why FCP levels are not critical for the classification system of DM in children. The findings of this study suggest that T1.5DM should be considered during the classification of pediatric DM and might facilitate more tailored approaches to treatment, clinical care and follow-up.
authors.affiliation: Department of Pediatric Endocrinology, Hospital Regional de Alta Especialidad del Bajío, León, Guanajuato, México.
authors.forename: María Lola
authors.initials: ML
authors.lastname: Evia-Viscarra
authors.affiliation: Department of Research, Hospital Regional de Alta Especialidad del Bajío, León, Guanajuato, México.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Guardado-Mendoza
authors.affiliation: Department of Research, Hospital Regional de Alta Especialidad del Bajío, León, Guanajuato, México.
authors.forename: Edel Rafael
authors.identifier: http://orcid.org/0000-0003-4287-9626
authors.initials: ER
authors.lastname: Rodea-Montero
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000378:metabolism*; D002096:C-Peptide / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000145:classification* / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico / Q000453:epidemiology; D010179:Pancreas / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D002096:C-Peptide; D002097:C-Reactive Protein