Haliloğlu Belma, Abalı Saygın, Buğrul Fuat, Çelik Enes, Baş Serpil, Atay Zeynep, Güran Tülay, Turan Serap, Bereket Abdullah
Yeditepe University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
Acibadem University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
J Clin Res Pediatr Endocrinol. 2018 Jun 1;10(2):125-130. doi: 10.4274/jcrpe.5204. Epub 2017 Nov 24.
Type 1 diabetes (T1D) is the most common cause of diabetes in childhood but type 2 diabetes (T2D) and maturity onset diabetes of the young (MODY) are emerging as noteworthy causes of diabetes at young ages. The aim is to determine the distribution, trends and clinical features of the different types of diabetes in childhood in one tertiary center.
The records of children and adolescents aged 0-18 years who were diagnosed as “diabetes/persistent hyperglycemia” between January 1999 and December 2016, were reviewed. Clinical and laboratory characteristics of the patients at diagnosis and type of diabetes were recorded.
The mean ± standard deviation age of 835 patients (48.7% females) at diagnosis was 8.8±4.4 years. Eighty-four percent of the patients were diagnosed as T1D, 5.7% as T2D, 5.3% as clinical MODY and 5% as being cases of other types of diabetes. The frequency of diabetic ketoacidosis (DKA) and severe DKA in T1D were 48.4% and 11.6%, respectively. Fourteen patients (29.2%) with T2D presented with ketosis and two of them (4.2%) had DKA at diagnosis. Antibody positivity was 83.1% in T1D and 14.8% in T2D. A statistically significant increase in the frequency of T2D has clearly been demonstrated in recent years with a frequency of 1.9%, 2.4% and 7.9% in 1999-2004, 2005-2010 and 2011-2016, respectively (p<0.001). In MODY, genetic analysis was performed in 26 (59%) patients and HNF1A and GCK gene mutations were detected in 3 (11.5%) and 14 (53.8%) patients, respectively.
Although the most frequent cause of DM is T1D in childhood, a trend towards increase in the frequency of T2D in recent years is notable in our population.
1型糖尿病（T1D）是儿童糖尿病最常见的病因，但2型糖尿病（T2D）和青年发病的成年型糖尿病（MODY）正逐渐成为儿童期糖尿病的重要病因。本研究旨在确定某三级中心儿童期不同类型糖尿病的分布、趋势及临床特征。
回顾1999年1月至2016年12月期间诊断为“糖尿病/持续性高血糖”的0至18岁儿童及青少年的病历。记录患者诊断时的临床和实验室特征以及糖尿病类型。
835例患者（48.7%为女性）诊断时的平均年龄±标准差为8.8±4.4岁。84%的患者被诊断为T1D，5.7%为T2D，5.3%为临床MODY，5%为其他类型糖尿病。T1D中糖尿病酮症酸中毒（DKA）和重度DKA的发生率分别为48.4%和11.6%。14例（29.2%）T2D患者诊断时出现酮症，其中2例（4.2%）发生DKA。T1D抗体阳性率为83.1%，T2D为14.8%。近年来T2D的发生率有显著统计学意义的增加，1999 - 2004年、2005 - 2010年和2011 - 2016年的发生率分别为1.9%、2.4%和7.9%（p<0.001）。在MODY患者中，对26例（59%）进行了基因分析，分别在3例（11.5%）和14例（53.8%）患者中检测到HNF1A和GCK基因突变。
虽然儿童期糖尿病最常见的病因是T1D，但近年来我们研究人群中T2D的发生率有上升趋势。
