Type 2 Diabetes, Medication-Induced Diabetes, and Monogenic Diabetes in Canadian Children: A Prospective National Surveillance Study

  1. Shazhan Amed, MD(samed{at}cw.bc.ca)(1),
  2. Heather J. Dean, MD(2),
  3. Constadina Panagiotopoulos, MD(1),
  4. Elizabeth A.C. Sellers, MD(2),
  5. Stasia Hadjiyanakis, MD(3),
  6. Tessa A. Laubscher, MBChB(4),
  7. David Dannenbaum, MD(5),
  8. Baiju R. Shah, MD(6),
  9. Gillian L. Booth, MD(6) and
  10. Jill K. Hamilton, MD(7)
  1. 1. Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4
  2. 2. Department of Pediatrics & Child Health, University of Manitoba
  3. 3. Assistant Professor of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario
  4. 4. Academic Family Medicine, University of Saskatchewan
  5. 5. Department of Family Medicine, McGill University
  6. 6. Institute for Clinical Evaluative Sciences, University of Toronto
  7. 7. University of Toronto, The Hospital for Sick Children

Abstract

Objectives: To determine in Canadian children <18 years the: 1) incidence of type 2 diabetes, medication-induced diabetes and monogenic diabetes, 2) clinical features of type 2 diabetes and 3) co-existing 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: 345 cases of non-type 1 diabetes were reported from a population of 7.3 million children. The observed minimum incidence rates of type 2, medication-induced, and monogenic diabetes were 1.54, 0.4, and 0.2 cases/100,000 children <18 years of age/year, respectively. On average, children with type 2 diabetes were 13.7 years and 8% (19/227) presented before 10 years. Ethnic minorities were over-represented, but 25% (57/227) of children with type 2 diabetes were Caucasian. 95% (206/216) of children with type 2 diabetes were obese and 37% (43/115) had at least one co-morbidity 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 co-morbidity should occur at diagnosis of type 2 diabetes.

Footnotes

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

This Article

  1. Published online before print January 12, 2010, doi: 10.2337/dc09-1013
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