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Type 2 diabetes in prepubertal children.

Marcela Astudillo1, Mustafa Tosur1, Beatriz Castillo2

  • 1Diabetes and Endocrinology Section, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.

Pediatric Diabetes
|August 7, 2021
PubMed
Summary
This summary is machine-generated.

Type 2 diabetes (T2D) in children diagnosed before puberty is rare but linked to severe obesity and insulin resistance. Early interventions for childhood obesity are crucial to prevent T2D-related complications.

Keywords:
childhood obesitydyslipidemiaheterogeneityprepubertalpubertytannertype 2 diabetes

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Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Puberty-associated insulin resistance is key in youth-onset type 2 diabetes (T2D).
  • Prepubertal T2D is rare, with limited data on its distinct risk factors and pathophysiology.
  • Understanding prepubertal T2D is vital for early diagnosis and management.

Purpose of the Study:

  • To characterize the clinical features of children diagnosed with T2D before puberty.
  • To compare prepubertal T2D cases with those diagnosed during or after puberty.

Main Methods:

  • Retrospective analysis of autoantibody-negative T2D cases with pubertal assessment.
  • Comparison of prepubertal (Tanner stage I) versus pubertal (Tanner II-V) children.
  • Statistical analysis adjusted for glucose, race/ethnicity, and sex.

Main Results:

  • Prepubertal T2D patients exhibited higher BMI z-scores and C-peptide levels than pubertal patients.
  • 100% of prepubertal children had dyslipidemia compared to 89.7% of pubertal children.
  • Prepubertal children diagnosed under age 10 were predominantly female, racial/ethnic minorities, and had obesity and dyslipidemia, with no diabetic ketoacidosis.

Conclusions:

  • Type 2 diabetes can occur before puberty, presenting with distinct clinical characteristics.
  • Prepubertal T2D is associated with more severe obesity, insulin resistance, and dyslipidemia.
  • Early childhood obesity interventions are critical for preventing and managing prepubertal T2D and its associated morbidities.