Etiology and glycemic control among Thai children and adolescents with diabetes mellitus.

BACKGROUND: There is little data on etiology and metabolic control in children and adolescents with diabetes in developing countries. OBJECTIVE: Determine the etiology of diabetes in Thai youths and to evaluate their glycemic control. MATERIAL AND METHOD: The authors retrospectively reviewed the case records of 157 patients seen at the Department of Pediatrics, Siriraj Hospital between 2003 and 2004. RESULT: Type 1 diabetes (T1D) comprised 83%, type 2 diabetes (T2D) 13%, and other types 4%. GAD65 and IA-2 antibodies were positive in 63% and 61% of T1D patients, and 0% and 9% of T2D patients, respectively. There were an increasing number of new cases, both T1D and T2D, during the study period compared with a previous study conducted at the hospital. Mean HbA1c in T1D and T2D were 8.9 +/- 2.1% and 6.2 +/- 1.80%, respectively (p < 0.001). CONCLUSION: Based on the present study, glycemic control appeared to be more satisfactory in T2D patients than those with T1D. Glycemic control among T1D patients was comparable to others in developed countries.

Leptin level in Thai children and adolescents: Relation to BMI and sexes.

Objective: The prevalence of obesity is rapidly increasing worldwide, including Thai children. Serum leptin is demonstrated largely that it increased in the dynamic phase in childhood –onset obesity. To our knowledge, there was no data of leptin measurement in this age group of our population. Methods: Therefore, we measured serum leptin by an immunoradiometric assay in sample from 208 obese and non-obese healthy children aged 2-18 years old. Its relationship to body mass index (BMI), ages and sexes were analyzed. Results: The mean serum leptin concentration in obese children was 35.06 + 17.31 ng/ml compared with 14.70 + 8.93 ng/ml in the non - obese children (p < 0.001). The obese female had significant higher level than in obese male group (43.26 + 16.82 vs. 30.34 + 15.85 ng/ml; p < 0.001), but they were not different in the non - obese group. The results showed that serum leptin correlated with BMI (r = 0.71; p < 0.001) and with % weight for height (%wt for ht) (r = 0.60, p < 0.001), respectively. Leptin levels in both sexes compared to age were also demonstrated. We did not find leptin deficiency or leptin resistance in all obese cases. Conclusion: In summary, leptin level in Thai children were increased according to BMI, % wt for ht and sexes as demonstrated in other ethnic groups. However, there is neither leptin deficiency nor leptin resistance demonstrated in this study.