Purpose Type 1 diabetes (T1D) is the most common type of diabetes in children, but the frequency of type 2 diabetes (T2D) is increasing rapidly. Classification of diabetes is based on a constellation of features that are typical of each type. We aimed to compare demographic, clinical and laboratory characteristics at diabetes diagnosis in pediatric T1D and T2D. Methods We studied children who attended a large academic hospital in Houston, Texas (USA) with a new diagnosis of T2D (n=753) or T1D (n=758). We compared age, sex, race/ethnicity, presence of obesity, glucose, hemoglobin A1c, islet autoantibody positivity, C-peptide, and presence of diabetic ketoacidosis (DKA) at diabetes diagnosis. Results At diagnosis of diabetes, children with T2D, compared with those with T1D, were older (13.6 vs 9.7% years old), more likely females (63.2% vs 47.8%), of racial/ethnic minority (91.1%% versus 42.3%) and obese (90.9% vs 19.4%), and were less likely to have DKA (7.8% vs 35.0%) and diabetes autoantibodies (5.5% vs 95.4%). Children with T2D also had significantly less marked elevation of glucose and hemoglobin A1c, and lower C-peptide levels (all comparisons, p<0.0001). In multiple logistic regression analysis, older age, racial/ethnic minority, obesity, higher C-peptide and negative islet autoantibodies were independently associated with T2D (all, p<0.05) while sex, glucose, hemoglobin A1c and DKA were not (model p<0.0001). Conclusions There are important demographic, clinical and laboratory differences between T1D and T2D in children. However, none of the characteristics was unique to either diabetes type, which poses challenges to diabetes classification at diagnosis.

中文翻译：

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新发儿童 1 型和 2 型糖尿病人口统计学和诊断标志物的比较

目的 1 型糖尿病 (T1D) 是儿童中最常见的糖尿病类型，但 2 型糖尿病 (T2D) 的发病率正在迅速增加。糖尿病的分类基于各种类型的典型特征。我们旨在比较儿童 T1D 和 T2D 糖尿病诊断的人口统计学、临床和实验室特征。方法 我们研究了在德克萨斯州休斯顿（美国）的一家大型学术医院就读的儿童，他们新诊断为 T2D（n=753）或 T1D（n=758）。我们在糖尿病诊断时比较了年龄、性别、种族/民族、肥胖的存在、葡萄糖、血红蛋白 A1c、胰岛自身抗体阳性、C 肽和糖尿病酮症酸中毒 (DKA) 的存在。结果 在诊断糖尿病时，与 T1D 儿童相比，T2D 儿童年龄更大（13.6% vs 9.7%），女性更可能（63.2% vs 47.8%），少数族裔（91.1% 对 42.3%）和肥胖（90.9% 对 19.4%），并且患 DKA（7.8% 对 35.0%）和糖尿病自身抗体（5.5% 对 95.4%）的可能性较小。患有 T2D 的儿童的葡萄糖和血红蛋白 A1c 的升高也明显较少，并且 C 肽水平较低（所有比较，p<0.0001）。在多元逻辑回归分析中，年龄较大、种族/少数族裔、肥胖、较高 C 肽和阴性胰岛自身抗体与 T2D 独立相关（所有，p < 0.05），而性别、葡萄糖、血红蛋白 A1c 和 DKA 无关（模型 p <0.0001)。结论 儿童 T1D 和 T2D 之间存在重要的人口统计学、临床和实验室差异。然而，这些特征都不是糖尿病类型所独有的，这对诊断时的糖尿病分类提出了挑战。