We read with interest the article by Eppens et al. (1) concerning the prevalence of diabetes complications in adolescents with type 2 compared with type 1 diabetes.
Because the study was clinic based and included a relatively small number of subjects with type 2 diabetes (n = 68), we present our findings from a nationwide screening program, which was conducted between 1992 and 1997 for all schoolchildren aged 6–18 years (2). Diabetes was diagnosed in 381 boys and 454 girls whose fasting blood glucose exceeded 7 mmol/l. Type 1 diabetes was considered if they received insulin therapy within 6 months and if it was confirmed by their referred physicians (2). Type 2 diabetes was considered if they were under diet control or were currently receiving oral antidiabetic agents without recurrent diabetic ketoacidosis. Those who received insulin injection within 3 years were excluded due to uncertainty in the classification of diabetes. Overweight and obesity were defined by 85th to 95th and above 95th percentile of age- and sex-specific cutoffs, whereas hypertension was diagnosed if systolic or diastolic blood pressure was >95th percentile of age- and sex-specific cutoffs in our population.
There were 330 subjects with type 1 diabetes and 505 subjects with type 2 diabetes. Hypertension was more prevalent in adolescents with type 2 than type 1 diabetes (44.4 vs. 23.4%, P < 0.001), which is similar to the report by Eppens et al. (1). After adjusting for age and sex, subjects with type 2 diabetes also showed a higher risk of hypertension (odds ratio 2.25 [95% CI 1.59–3.20], P < 0.001).
Similar to the findings by Eppens et al., adolescents with type 2 diabetes had a higher rate of obesity in our population (45.4 vs. 8.8%, P < 0.001). However, we found a higher rate of overweight in those with type 2 diabetes (10.1 vs. 7.2%, P < 0.001), which was not observed by Eppens et al. When applying the same definition of overweight and obesity (3), as Eppens et al. did, adolescents with type 2 diabetes also showed a higher rate of both overweight and obesity (overweight 28.6 vs. 15.0%, P < 0.001; obesity 30.0 vs. 7.2%, P < 0.001).
The findings of our population-based study support and extend the observations by Eppens et al., showing that adolescents with type 2 diabetes were more obese and had a higher rate of hypertension than those with type 1 diabetes.
