Clinical implication of transient hyperglycemia in childhood

The incidence of insulin-dependent diabetes (IDDM) in Chinese is much lower than for Western persons. The study was designed to determine whether Chinese children with transient hyperglycemia would develop diabetes as frequently as Western children. Ten children presenting with transient hyperglycemia were investigated using glucagon stimulation test, oral glucose tolerance test (OGTT) and i.v. glucose tolerance test (IVGTT) to estimate pancreatic insulin secretory function. They were followed up for one to three years. Islet cell antibodies and insulin autoantibodies were also measured. During the follow-up period, 2 of the 10 children developed diabetes at 1 month and 1 year, respectively, after the occurrence of transient hyperglycemia. Both of them had lower C-peptide peak level to glucagon stimulation, decreased first phase insulin release to IVGTT and a diabetic sibling. Islet cell antibodies and insulin autoantibodies were all negative except in one of the two children who later developed diabetes. Although it is still premature owing to the small sample size to conclude that Chinese children with transient hyperglycemia are less likely to develop diabetes than Western children, it is advisable to closely follow up those with a family history of IDDM who seem to be at the greatest risk.