Type 2 diabetes, medication-induced diabetes, and monogenic diabetes in Canadian children: a prospective national surveillance study.
Type 2 diabetes, medication-induced diabetes, and monogenic diabetes in Canadian children: a prospective national surveillance study.
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DOI：
10.2337/dc09-1013
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发表时间：
2010-04
期刊：
影响因子：
16.2
通讯作者：
Hamilton JK
中科院分区：
文献类型：
--
作者：
Amed S;Dean HJ;Panagiotopoulos C;Sellers EA;Hadjiyannakis S;Laubscher TA;Dannenbaum D;Shah BR;Booth GL;Hamilton JK
确定加拿大18岁以下儿童的1）2型糖尿病、药物诱导糖尿病和单基因糖尿病的发病率; 2）2型糖尿病的临床特征; 3）诊断时与2型糖尿病相关的共存发病率。这项加拿大前瞻性国家监测研究涉及儿科医生、儿科内分泌学家、家庭医生和成人内分泌学家的网络。使用加拿大人口普查数据计算发病率。使用描述性统计来说明人口统计学和临床特征。在730万儿童中，报告了345例非1型糖尿病。观察到的2型糖尿病、药物诱导糖尿病和单基因糖尿病的最低发病率分别为每年每10万名18岁以下儿童1.54例、0.4例和0.2例。平均而言，2型糖尿病儿童的年龄为13.7岁，8%（227人中的19人）在10年前出现。少数民族的比例过高，但25%（57/227）的2型糖尿病儿童是白人。在2型糖尿病儿童中，95%（206/216）为肥胖，37%（43/115）在诊断时至少有一种合并症。这是加拿大第一个报告儿童2型糖尿病发病率的前瞻性国家监测研究，也是世界上第一个报告药物诱导和单基因糖尿病发病率的研究。2型糖尿病的发病率高于预期，但存在重要的地区差异。这些结果支持在诊断2型糖尿病时应进行合并症筛查的建议。
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. 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. 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. 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.