Autoantibody Positivity and Clinical Characteristics of Diabetes Mellitus in Childhood / 대한소아내분비학회지

ABSTRACT

PURPOSE: Most childhood diabetes mellitus (DM) is usually thought of as type 1 DM (T1DM), but the incidence of type 2 DM (T2DM) in childhood is increasing. Sometimes, it might not be easy to determine which type of DM a patient has and to choose the best treatment. The purpose of this study is to evaluate the usefulness of autoantibody test and clinical characteristics for the specific diagnosis of DM in childhood. METHODS: In this study, we retrospectively reviewed the medical records of 42 patients who were diagnosed with DM and followed at the department of pediatrics, Dankook University Hospital from January 2002 to October 2010. RESULTS: The patients were grouped as T1DM, T2DM, or T1.5DM (unclassified) according to the clinical and laboratory findings. T1DM had an earlier onset age compared to T2DM. Diabetic ketoacidosis (DKA) was the presenting symptom in 57% of T1DM, but there was no DKA in T2DM. Initial serum insulin and C-peptide levels were lower in T1DM than T2DM. Thirty nine percent and 70% of the patients had a family history of DM, respectively. The average body mass index (BMI) in T2DM was higher than that in T1DM. At least one of autoantibodies was positive in 80% of T1DM. But no antoantibody was detected in T2DM. During follow up, higher levels of HbA1c and more frequent microalbuminuria were detected in the female adolescents. CONCLUSION: We can confirm that the autoantibody test is very valuable in diagnosing specific types of DM. And adolescent period was thought as a very vulnerable period to manage the diabetes requiring more intensive emotional support including family cooperation.