PCOS is a common endocrine disorder that starts in adolescence and, when accompanied by obesity, is associated with a 4-fold risk of T2D. Adolescent onset of T2D carries significant morbidity and decreased life expectancy; rates of T2D are 12.5 cases/100,000/year in the general youth population. The incidence and prevalence of T2D in teen girls with PCOS and obesity are unknown. We conducted a retrospective chart review at a large tertiary care center. Using ICD9/10 codes for PCOS, girls aged 11-21 years with clinic visits between 7/1/2013-8/15/2018 and a BMI %ile > 85th were identified. Diagnosis of PCOS and T2D were confirmed using Endocrine Society and ADA guidelines, respectively. Key demographic and diagnostic information, including time of T2D diagnosis relative to PCOS diagnosis, was extracted. Prevalence of T2D in the PCOS cohort was calculated 1) from the entire T2D cohort and 2) only the incident T2D cases, as our site may have excess new T2D diagnosis referrals. We identified 600 cases of PCOS (15.2 ± 1.8 years, BMI %ile 96.2 ± 12.1) and 54 of these also had T2D, of whom 23 were diagnosed with PCOS prior to T2D (incident cohort). The prevalence of T2D in girls with PCOS and overweight/obesity was 4% including only incident cases and 9% with inclusion of all T2D. The incidence of T2D among adolescents with obesity and PCOS is 129 cases/1000/year and T2D presents 26 ± 19 months after PCOS diagnosis. Girls with T2D were more likely to be Hispanic (67% vs. 49%; p<0.0001) have obstructive sleep apnea (32% vs. 17%; p=0.01) and a 1st-degree relative with T2D (56% vs. 22%; p<0.001) than those who didn’t develop T2D. Girls with PCOS and obesity are at high-risk for developing T2D in adolescence, with 1 in 23 developing T2D within 2 years of diagnosis with PCOS. Girls at higher risk include those with a strong family history of T2D and Hispanic ethnicity. Further work is needed to confirm these rates in the overall adolescent population and to develop strategies for prevention of T2D in these high-risk youth.
J. Hudnut-Beumler: None. J. Kaar: None. L. Pyle: None. M.M. Kelsey: None. K.J. Nadeau: None. P. Zeitler: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Research & Development, Merck & Co., Inc., Novo Nordisk Inc. M. Cree-Green: None.
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK107871)