Increasing Prevalence of Pediatric Type 2 Diabetes in the Republic of Ireland: A National Cross-Sectional Study

Aims: To establish the current prevalence of type 2 diabetes in children and adolescents aged under 16 years in the Republic of Ireland, to identify modes of presentation, patient characteristics, comorbidities, management, and outcomes. Methods: We conducted a cross-sectional study of children and adolescents aged under 16 years with a diagnosis of type 2 diabetes in September 2023 using a standardized proforma. This was circulated to all clinicians providing care to children with diabetes in all 19 centers in the Republic of Ireland. Results: Thirty-two cases of type 2 diabetes were identified, giving an estimated prevalence in children and adolescents under 16 years of 3/100,000 population, a significant increase from 1.2/100,000 population in 2015 (p  < 0.004). This was due to increased prevalence rates in, both White and Asian populations, as well as an increase in the size of the Asian population under 16. Nineteen (59%) were girls. Median duration of diabetes was 1.2 (0.1-4.9) years. Median body mass index (BMI) z-score at diagnosis was identical to the 2015 study (+2.3). Sixteen (50%) achieved the target HbA1c specified by the International Society for Pediatric and Adolescent Diabetes (ISPAD) of 48 mmol/mol (6.5%) or less. Completion of screening for comorbidities and complications of type 2 diabetes were not in accordance with guidelines. Conclusion: There has been a significant increase in the prevalence of type 2 diabetes in under 16's in a short timeframe. Establishment of a National Diabetes Register will facilitate ongoing monitoring of disease epidemiology in this and other age cohorts.