Clinical and biochemical characteristics of early onset type 2 diabetes in young diabetics

ABSTRACT

Early onset type 2 diabetes is no longer rare. Many studies have shown a trend to an earlier age of onset of type 2 DM and pointing to a loosing of the relative protection of young age to type 2 DM, largely attributable to the fattening of modem society. A descriptive study was conducted on a series of 19 early onset type 2 diabetics. Typical insulin-resistant phenotypes were described in these youngsters. Mean Age 17.53 +/- 1.4 years. All patients are overweight [n = 6, 16%] to obese [n = 13, 84%] at diagnosis with mean BMI [31.43 +/- 2.09 Kg/ m2] and mean waist circumference is [94 +/- 1.7 cm in females and 103.43 +/- 1.24 cm in males]. Hypertension was reported in 3 cases with mean systolic blood pressure [SBP] 134.32 +/- 8.45 and mean diastolic blood pressure [DBP] 87.05 +/- 10.34. Family History of type 2 diabetes was reported in 68.4% of the patients and maternal history Of Gestational DM presents in 52.6%. Ten patients [52.6%] have acanthosis nigricans; a cutaneous marker of insulin resistance. 6 female patients [out of 12] had clinical features suggestive of PCOS in the form of irregular menses and hirsutism. HOMA as a measure of insulin resistance was found to have a strong positive correlation with BMI, waist circumference in females, TG, DBP and a negative correlation with HDL-C and Apo A-1.Similarly hsCRP showed a positive correlation with BMI, waist circumference in females and males, TG, DBP and a negative correlation with HDL-C. In conclusion, early onset type 2 DM is increasingly recognized as a part of the accelerating epidemic in the world. This phenomenon is strongly associated with obesity and in particular, central adiposity, as a determinant of insulin resistant and chronic inflammatory states which seam to appear very early in these youngsters. Type 2 DM is frequently asymptomatic and should be considered in obese adolescent from at-risk ethnic groups who have positive family histories