1249-P: Type 2 Diabetes in Prepubertal Children under 10 Years Old

Only a few cases of type 2 diabetes (T2D) have been reported in children younger than 10 years of age. Given the aggressiveness of youth-onset T2D and the accelerated development of comorbidities and complications, recognition of this unique subgroup and its characteristics is imperative. We aimed to determine the prevalence and characteristics of children with T2D diagnosed <10 years old (y/o) at a large academic pediatric hospital in the Southwestern U.S. We conducted a retrospective review of electronic medical records of 1,138 children and adolescents up to 21 years of age who were given a diagnosis of T2D in our clinic. We compared the demographic and biochemical characteristics at the time of diabetes diagnosis between children diagnosed <10 y/o vs. ≥10 y/o, and by puberty status within the <10 y/o group. In our overall T2D population, 67.3% were females, 9.9% non-Hispanic White (NHW), 59% Hispanic (Hisp), 26.8% African-American (AA). The mean age at diagnosis was 13.8± 2.6 (±SD) y/o (range 3.0-21.7). The children diagnosed with T2D <10 y/o constituted 5.6%, n=64 of our total T2D population; mean age 8.8± 1.0 y/o (range 4.1-9.9). 52.2% were prepubertal (Tanner Stage [TS]-I). 81.2% had islet autoantibodies test available (including GAD, ICA-512 and IAA) and all had negative results. Children with T2D diagnosed <10 y/o were more likely to be female (79.7%) than youth diagnosed ≥10 y/o (61.4%, p=0.003). We observed no racial/ethnic distribution differences between the two groups (p=0.58). Within the group diagnosed <10 y/o, children who were prepubertal, compared with those at ≥TS-II, were more likely to be male (33.3% vs. 0%, p=0.035), had a higher BMI-Z score (2.71 vs. 2.47, p=0.036), and tended to have a different racial/ethnic distribution (83.3% Hisp and 16.7% AA vs. 45.5% and 54.6%, respectively, p=0.057).

In conclusion, less than 10% of youth with T2D are diagnosed under age 10 years; those in this group who are prepubertal (>50%) are distinctly atypical and have other unique characteristics that warrant further study.