ESPE Abstracts

Aim: This study aims to investigate the presentation characteristics, follow-up, and treatment modalities in children and adolescents diagnosed with Type 2 Diabetes (T2D).

Materials and Methods: This retrospective chart review includes 50 patients aged 4-20 years diagnosed with T2D between February 2013 and October 2023 according to American Diabetes Association (ADA) criteria in pediatric endocrinology clinic of a university hospital.

Results: The mean age at diagnosis was 13.4±2.5 years, with a female predominance of 66% (n = 33). Hyperglycemia was the main reason for presentation in 74% of patients, but only 52% (n = 26) were symptomatic, with polyuria (34%) and polydipsia (38%). Forty-six patients (92%) were classified as obese (68%) or overweight (24%). Acanthosis nigricans was present in 41 patients (82%). A significant trend towards earlier diagnosis was observed between three generations with the mean ages at diagnosis being 36.7±8.6 years for the second generation and 57.0±10.9 years for the third generation (P <0.001). The mean HbA1c value at diagnosis was 9.0±3.0%. Median basal insulin and c-peptide levels were 23.2 mIU/L (range 4.8-151) and 3.6 μg/L (range 1.0-9.0), respectively. Anti-GAD antibodies were positive in 4% of the patients and other autoantibodies were negative. When the treatment modalities were analysed, 46% (n = 23) were initiated on metformin monotherapy, 24% (n = 12) on insulin monotherapy, and 30% (n = 15) on a combination of metformin and insulin. After an average follow-up period of 5.4 years, 45.7% of the patients needed insulin, 20.1% needed metformin treatment and treatment had discontinued in 34.2%.

Conclusion: This retrospective study demonstrates a significant shift towards earlier ages at diabetes diagnosis between three generations, in addition to similar descriptive findings with previous studies.