Participants: Primary ascertainment was from the Australasian Paediatric Endocrine Group NSW Diabetes Register, with secondary ascertainment from the National Diabetes Register (Australian Institute of Health and Welfare).
Results: There were 128 incident cases of T2DM (62 boys, 66 girls) in the study period. The median age at diagnosis was 14.5 years (interquartile range, 13.0–16.4), and 90% were overweight or obese (body mass index > 85th percentile for age). Mean annual incidence was 2.5/100 000 person-years (95% CI, 2.1–3.0) in 10–18-year-olds. Of the ethnic groups represented, white Australian comprised 29%, Indigenous 22%, Asian 22%, North African/Middle Eastern 12% and Māori/Polynesian/Melanesian 10%. The incidence of T2DM was significantly higher in the Indigenous than the non-Indigenous group (incidence rate ratio, 6.1; 95% CI, 3.9–9.7; P < 0.001), but incidence rates of T1DM were similar (15.5 v 21.4/100 000, respectively).
Conclusions: T2DM accounts for 11% of incident cases of diabetes in 10–18-year-olds, and the majority are overweight or obese. The high rate among Indigenous Australian children supports screening for T2DM in this population.
- 1. Pinhas-Hamiel O, Zeitler P. The global spread of type 2 diabetes mellitus in children and adolescents. J Pediatr 2005; 146: 693-700.
- 2. Likitmaskul S, Kiattisathavee P, Chaichanwatanakul K, et al. Increasing prevalence of type 2 diabetes mellitus in Thai children and adolescents associated with increasing prevalence of obesity. J Pediatr Endocrinol Metab 2003; 16: 71-77.
- 3. Wei JN, Sung FC, Lin CC, et al. National surveillance for type 2 diabetes mellitus in Taiwanese children. JAMA 2003; 290: 1345-1350.
- 4. Hotu S, Carter B, Watson PD, et al. Increasing prevalence of type 2 diabetes in adolescents. J Paediatr Child Health 2004; 40: 201-204.
- 5. McMahon SK, Haynes A, Ratnam N, et al. Increase in type 2 diabetes in children and adolescents in Western Australia. Med J Aust 2004; 180: 459-461. <MJA full text>
- 6. Ettinger LM, Freeman K, Dimartino-Nardi JR, Flynn JT. Microalbuminuria and abnormal ambulatory blood pressure in adolescents with type 2 diabetes mellitus. J Pediatr 2005; 147: 67-73.
- 7. Scott A, Toomath R, Bouchier D, et al. First national audit of the outcomes of care in young people with diabetes in New Zealand: high prevalence of nephropathy in Maori and Pacific Islanders. N Z Med J 2006; 119: U2015.
- 8. Eppens MC, Craig ME, Cusumano J, et al. Prevalence of diabetes complications in adolescents with type 2 compared with type 1 diabetes. Diabetes Care 2006; 29: 1300-1306.
- 9. Levitt Katz LE, Swami S, Abraham M, et al. Neuropsychiatric disorders at the presentation of type 2 diabetes mellitus in children. Pediatr Diabetes 2005; 6: 84-89.
- 10. Fagot-Campagna A, Pettitt DJ, Engelgau MM, et al. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr 2000; 136: 664-672.
- 11. Dean HJ, Young TK, Flett B, Wood-Steiman P. Screening for type-2 diabetes in aboriginal children in northern Canada. Lancet 1998; 352: 1523-1524.
- 12. Braun B, Zimmermann MB, Kretchmer N, et al. Risk factors for diabetes and cardiovascular disease in young Australian Aborigines. A 5-year follow-up study. Diabetes Care 1996; 19: 472-479.
- 13. Craig ME, Howard NJ, Silink M, Chan A. The rising incidence of childhood type 1 diabetes in New South Wales, Australia. J Pediatr Endocrinol Metab 2000; 13: 363-372.
- 14. Taplin CE, Craig ME, Lloyd M, et al. The rising incidence of childhood type 1 diabetes in New South Wales, 1990-2002. Med J Aust 2005; 183: 243-246. <MJA full text>
- 15. Australian Institute of Health and Welfare. National Diabetes Register: impact of changed consent arrangements on ascertainment from the National Diabetes Services Scheme. Canberra: AIHW, 2006. (Diabetes Series No. 5, Catalogue No. CVD 35.)
- 16. American Diabetes Association. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2003; 26 Suppl 1: S5-S20.
- 17. Australian Bureau of Statistics. Australian standard classification of cultural and ethnic groups (ASCCEG). Canberra: ABS, 2005. (Catalogue No. 1249.0).
- 18. Australian Bureau of Statistics. National localities index. Canberra: ABS, 2004. (Catalogue No. 1252.0.)
- 19. Australian Bureau of Statistics. Population estimates by age and sex, New South Wales by geographic classification [ASGC 2005]. Canberra: ABS, 2005. (Catalogue No. 3235.1.55.001.)
- 20. Haenszel W, Loveland DB, Sirken MG. Lung-cancer mortality as related to residence and smoking histories. I. White males. J Natl Cancer Inst 1962; 28: 947-1001.
- 21. Craig ME, Hattersley A, Donaghue K; International Society for Pediatric and Adolescent Diabetes. ISPAD Clinical Practice Consensus Guidelines 2006–2007. Definition, epidemiology and classification. Pediatr Diabetes 2006; 7: 352-360.
- 22. Craig ME, Howard NJ, Silink M, Rawlinson WD. Reduced frequency of HLA DRB1*03-DQB1*02 in children with type 1 diabetes associated with enterovirus RNA. J Infect Dis 2003; 187: 1562-1570.
- 23. Eppens MC, Craig ME, Jones TW, et al. Type 2 diabetes in youth from the Western Pacific region: glycaemic control, diabetes care and complications. Curr Med Res Opin 2006; 22: 1013-1020.
- 24. Mackerras DE, Reid A, Sayers SM, et al. Growth and morbidity in children in the Aboriginal Birth Cohort Study: the urban-remote differential. Med J Aust 2003; 178: 56-60.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.