Skip to main content

Advertisement

SpringerLink
Log in

Childhood and Youth Onset Diabetes: A Single Centre Experience

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To identify proportion of various types of diabetes and differences between type 1 and type 2 diabetes in patients with youth onset diabetes (onset below 25 completed years of age). In addition, concurrent autoimmune diseases in type 1 diabetes were studied in a subset of patients.

Methods

A total of 577 patients (192 girls) with diabetes onset at median age of 14 y (range 1 mo–25 y) with median duration of 1 y (range day of diagnosis- 43 y) were included. Clinical details, investigations and complications were recorded in a proforma. Diabetes was classified using clinical criteria supported by laboratory tests of C peptide and anti GAD-65 antibody in a subset of patients.

Results

Type 1 diabetes accounted for 368/421 (87.4 %) patients with age of onset <18 y and 99/156 (63.5 %) of patients with onset between 19 and 25 y of age. Proportion of type 2 diabetes was 36/421 (8.5 %) and 41/156 (26.2 %) in these two groups. Older age at onset, diabetes in one or both parents, absence of ketosis /weight loss and presence of acanthosis were significant predictors of type 2 diabetes. Hypothyroidism (TSH >10) and biopsy proven celiac disease was found in 11.6 and 9.7 % of type 1 diabetes patients respectively.

Conclusions

Type 1 diabetes is the most common type of diabetes in youth, however, a significant proportion of youth have type 2 diabetes. In these patients a combination of clinical factors, biochemical parameters and course over few months helps to guide the diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Patterson C, Guariguata L, Dahlquist G, Soltész G, Ogle G, Silink M. Diabetes in the young—a global view and worldwide estimates of numbers of children with type 1 diabetes. Diabetes Res Clin Pract. 2014;103:161–75.

    Article  PubMed  Google Scholar 

  2. Kitagawa T, Owada M, Urakami T, Yamauchi K. Increased incidence of non-insulin dependent diabetes mellitus among Japanese schoolchildren correlates with an increased intake of animal protein and fat. Clin Pediatr (Phila). 1998;37:111–5.

    Article  CAS  Google Scholar 

  3. SEARCH for Diabetes in Youth Study Group, Liese AD, D’Agostino RB Jr, Hamman RF, et al. The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics. 2006;118:1510–8.

  4. Bhatia E. Type 1 diabetes mellitus in India. Curr Diab Rep. 2012;12:224–6.

    Article  PubMed  Google Scholar 

  5. Unnikrishnan AG, Bhatia E, Bhatia V, et al. Type 1 diabetes versus type 2 diabetes with onset in persons younger than 20 years of age. Ann N Y Acad Sci. 2008;1150:239–44.

    Article  CAS  PubMed  Google Scholar 

  6. Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125:217–30.

    CAS  PubMed  Google Scholar 

  7. Amutha A, Datta M, Unnikrishnan IR, et al. Clinical profile of diabetes in the young seen between 1992 and 2009 at a specialist diabetes centre in south India. Prim Care Diabetes. 2011;5:223–9.

    Article  PubMed  Google Scholar 

  8. American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37:S14–80.

    Article  Google Scholar 

  9. Khadilkar VV, Khadilkar AV, Choudhury P, Agarwal KN, Ugra D, Shah NK. IAP growth monitoring guidelines for children from birth to 18 years. Indian Pediatr. 2007;44:187–97.

    CAS  PubMed  Google Scholar 

  10. Misra A, Chowbey P, Makkar BM, et al; Concensus Group. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India. 2009;57:163–70.

  11. Zeitler P, Fu J, Tandon N, et al; International Society for Pediatric and Adolescent Diabetes. ISPAD Clinical Practice Consensus Guidelines 2014. Type 2 diabetes in the child and adolescent. Pediatr Diabetes. 2014;15:26–46.

  12. Bhatia V, Arya V, Dabadghao P, et al. Etiology and outcome of childhood and adolescent diabetes mellitus in North India. J Pediatr Endocrinol Metab. 2004;17:993–9.

    Article  CAS  PubMed  Google Scholar 

  13. Anjana RM, Pradeepa R, Deepa M, et al; ICMR–INDIAB Collaborative Study Group. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: phase I results of the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study. Diabetologia. 2011;54:3022–7.

  14. Zeitler P. Approach to the obese adolescent with new-onset diabetes. J Clin Endocrinol Metab. 2010;95:5163–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Copeland KC, Zeitler P, Geffner M, et al; TODAY Study Group. Characteristics of adolescents and youth with recent-onset type 2 diabetes: the TODAY cohort at baseline. J Clin Endocrinol Metab. 2011;96:159–67.

  16. Vikram NK, Tandon N, Misra A, et al. Correlates of type 2 diabetes mellitus in children, adolescents and young adults in north India: a multisite collaborative case–control study. Diabet Med. 2006;23:293–8.

    Article  CAS  PubMed  Google Scholar 

  17. Amutha A, Datta M, Unnikrishnan R, Anjana RM, Mohan V. Clinical profile and complications of childhood- and adolescent-onset type 2 diabetes seen at a diabetes centre in south India. Diabetes Technol Ther. 2012;14:497–504.

    Article  CAS  PubMed  Google Scholar 

  18. Dhanwal DK, Agarwal S, Garg S, Agarwal P. Clinical & immunological profile of newly diagnosed patients with youth onset diabetes mellitus. Indian J Med Res. 2014;140:356–60.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Volta U, Tovoli F, Caio G. Clinical and immunological features of celiac disease in patients with Type 1 diabetes mellitus. Expert Rev Gastroenterol Hepatol. 2011;5:479–87.

    Article  CAS  PubMed  Google Scholar 

  20. Bhadada SK, Kochhar R, Bhansali A, et al. Prevalence and clinical profile of celiac disease in type 1 diabetes mellitus in north India. J Gastroenterol Hepatol. 2011;26:378–81.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors acknowledge the help of Dr Vibha Dhingra, Ms Garima Rastogi, Mr Uday Shankar, Ms Shubhda Bhanot, Ms Sonal Kalra and Ms Parul Malhotra in collection of the data.

Contributions

GSJ and CK co-ordinated the study and data collection. CK, SS, JKA, SKM, JSW were involved in data collection and classification of patients. PK and KJF were involved in statistical analysis. GSJ prepared the first draft of the manuscript. BB and AM critically reviewed the first draft and revisions of the manuscript. AM guided the study and reviewed all the versions of the manuscript.

Author information

Authors and Affiliations

  1. Division of Endocrinology and Diabetes, Medanta The Medicity, Sector 38, Gurgaon, Haryana, 122 001, India

    Ganesh Jevalikar, Chhavi Kohli, Beena Bansal, Sunil Kumar Mishra, Jasjeet Singh Wasir, Shweta Singh, Jasmine Kaur Ahuja, Parjeet Kaur, Khalid J. Farooqui & Ambrish Mithal

Authors
  1. Ganesh Jevalikar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chhavi Kohli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Beena Bansal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sunil Kumar Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jasjeet Singh Wasir
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shweta Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jasmine Kaur Ahuja
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Parjeet Kaur
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Khalid J. Farooqui
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ambrish Mithal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ganesh Jevalikar.

Ethics declarations

Conflict of Interest

None.

Source of Funding

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jevalikar, G., Kohli, C., Bansal, B. et al. Childhood and Youth Onset Diabetes: A Single Centre Experience. Indian J Pediatr 83, 792–798 (2016). https://doi.org/10.1007/s12098-015-2009-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-015-2009-7

Keywords

Search

Navigation