Type 2 Diabetes, Medication-Induced Diabetes, and Monogenic Diabetes in Canadian Children

A prospective national surveillance study

  1. Jill K. Hamilton, MD7
  1. 1Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada;
  2. 2Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada;
  3. 3Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada;
  4. 4Academic Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada;
  5. 5Department of Family Medicine, McGill University, Montreal, Quebec, Canada;
  6. 6Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada;
  7. 7University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.
  1. Corresponding author: Shazhan Amed, samed{at}cw.bc.ca.

Abstract

OBJECTIVE To determine in Canadian children aged <18 years the 1) incidence of type 2 diabetes, medication-induced diabetes, and monogenic diabetes; 2) clinical features of type 2 diabetes; and 3) coexisting morbidity associated with type 2 diabetes at diagnosis.

RESEARCH DESIGN AND METHODS This Canadian prospective national surveillance study involved a network of pediatricians, pediatric endocrinologists, family physicians, and adult endocrinologists. Incidence rates were calculated using Canadian Census population data. Descriptive statistics were used to illustrate demographic and clinical features.

RESULTS From a population of 7.3 million children, 345 cases of non–type 1 diabetes were reported. The observed minimum incidence rates of type 2, medication-induced, and monogenic diabetes were 1.54, 0.4, and 0.2 cases per 100,000 children aged <18 years per year, respectively. On average, children with type 2 diabetes were aged 13.7 years and 8% (19 of 227) presented before 10 years. Ethnic minorities were overrepresented, but 25% (57 of 227) of children with type 2 diabetes were Caucasian. Of children with type 2 diabetes, 95% (206 of 216) were obese and 37% (43 of 115) had at least one comorbidity at diagnosis.

CONCLUSIONS This is the first prospective national surveillance study in Canada to report the incidence of type 2 diabetes in children and also the first in the world to report the incidence of medication-induced and monogenic diabetes. Rates of type 2 diabetes were higher than expected with important regional variation. These results support recommendations that screening for comorbidity should occur at diagnosis of type 2 diabetes.

Footnotes

  • All researchers functioned independently of organizations that funded this study. This article is based on information gathered through the Canadian Paediatric Surveillance Program. The views, opinions, and/or conclusions expressed by the author(s) are their own and do not necessarily reflect the views, opinions, and/or conclusions of the Canadian Paediatric Society, the Public Health Agency of Canada, or the Canadian Paediatric Surveillance Program.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received June 2, 2009.
    • Accepted January 6, 2010.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

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  1. Diabetes Care vol. 33 no. 4 786-791
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