Challenges in the diagnosis of diabetes type in pediatrics. Issue 7 (23rd July 2020)

• Record Type: Journal Article
• Authors: Siller, Alejandro F.; Tosur, Mustafa; Relan, Shilpi; Astudillo, Marcela; McKay, Siripoom; Dabelea, Dana; Redondo, Maria J.
• Is Part Of: Pediatric diabetes. Volume 21:Issue 7(2020)
• Page Start: 1064
• Page End: 1073
• Publication Date: 2020-07-23
• Subjects: delayed diagnosis -- diabetes complications -- diabetes mellitus -- MODY -- pediatrics; Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.13070
• Languages: English
• ISSNs: 1399-543X

Abstract

Abstract: The incidence of diabetes, both type 1 and type 2, is increasing. Health outcomes in pediatric diabetes are currently poor, with trends indicating that they are worsening. Minority racial/ethnic groups are disproportionately affected by suboptimal glucose control and have a higher risk of acute and chronic complications of diabetes. Correct clinical management starts with timely and accurate classification of diabetes, but in children this is becoming increasingly challenging due to high prevalence of obesity and shifting demographic composition. The growing obesity epidemic complicates classification by obesity's effects on diabetes. Since the prevalence and clinical characteristics of diabetes vary among racial/ethnic groups, migration between countries leads to changes in the distribution of diabetes types in a certain geographical area, challenging the clinician's ability to classify diabetes. These challenges must be addressed to correctly classify diabetes and establish an appropriate treatment strategy early in the course of disease for all. This may be the first step in improving diabetes outcomes across racial/ethnic groups. This review will discuss the pitfalls in the current diabetes classification scheme that is leading to increasing overlap between diabetes types and heterogeneity within each type. It will also present proposed alternative classification schemes and approaches to understanding diabetes type that may improve the timely and accurate classification of pediatric diabetes type.