Authors: Eppens, Maike C.¹; Craig, Maria E.²; Jones, Timothy W.³; Silink, Martin⁴; Ong, Stephanie⁵; Ping, Yeo Jing⁵; The International Diabetes Federation Western Pacific Region Steering Committee,

Source: Current Medical Research and Opinion, Volume 22, Number 5, May 2006 , pp. 1013-1020(8)

Publisher: Informa Healthcare

Abstract:

Objective: To describe the glycaemic control, diabetes care and prevalence of complications in youth with type 2 diabetes from the Western Pacific Region.

Research design and methods: Cross-sectional, clinic-based audit of 331 patients aged < 18 years from 56 centres in Australia, China-Beijing, China-Shanghai, China-Hong Kong, Indonesia, Japan, South Korea, Malaysia, Philippines, Singapore, Taiwan and Thailand. Clinical and management data were recorded along with glycated haemoglobin (HbA_1c), lipids and complication rates.

Main outcome measures: Glycaemic control, complications, diabetes management.

Results: Median age was 14.9 years (interquartile range 13.2–16.4 years) and median diabetes duration 2.3 years (1.4–3.6 years). Median HbA_1c was 7% (5.9–9.9%) and HbA_1c was > 7.5% in 40% of patients. In multiple regression analysis, glycaemic control varied significantly between countries (p = 0.02); higher HbA_1c was associated with fewer home blood glucose measurements (p = 0.005) and higher insulin dose/kg (p < 0.0001). Blood glucose monitoring was performed by 65% of patients (range 33–96% by country). In 25% of patients, management consisted of diet alone or no treatment (range 0–53% by country); oral anti-diabetic drugs alone were used in 49%, insulin alone in 11% and both in 15%. Microalbuminuria was found in 8% and hypertension in 24%. The risk of hypertension increased with higher BMI (OR 1.16, 95% CI 1.09–1.24, p < 0.0001); antihypertensive agents were used in 4% of patients.

Conclusions: The management of type 2 diabetes in youth from the Western Pacific Region varies widely. Hypertension and microalbuminuria were frequent, but not commonly treated. Further investigation into the natural history and risk factors for complications in youth with type 2 diabetes is required to assist in developing evidence based management guidelines.

Keywords: HBA1C; HYPERTENSION; MICROALBUMINURIA; TYPE 2 DIABETES; YOUTH

Document Type: Research article

DOI: http://dx.doi.org/10.1185/030079906X104795

Affiliations: 1: The Children's Hospital at Westmead, Sydney, NSW and Discipline of Paediatrics and Child Health, University of Sydney, NSW, Australia; University of Leiden, The Netherlands 2: The Children's Hospital at Westmead, Sydney, NSW and Discipline of Paediatrics and Child Health, University of Sydney, NSW, Australia; Department of Paediatrics, St George Hospital, Gray Street, Kogarah, NSW, and School of Women's and Children's 3: Department of Diabetes and Endocrinology, Princess Margaret Hospital for Children, Perth, WA, Australia 4: The Children's Hospital at Westmead, Sydney, NSW and Discipline of Paediatrics and Child Health, University of Sydney, NSW, Australia 5: Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, WA, Australia

Publication date: 2006-05-01

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