Presentation and 5-year Follow-Up of Type 2 Diabetes Mellitus in African-American and Caribbean-Hispanic Adolescents

Horm Res. 2003;60(3):121-6. doi: 10.1159/000072523.

Abstract

Objective: We report the presentation and 5-year follow-up of 89 African-American (AA) and Caribbean-Hispanic (CH) youths with type 2 diabetes mellitus (T2DM) followed at the Montefiore Medical Center, Bronx, N.Y., USA, from 1990 to 2000.

Methods: The medical records of 89 patients with T2DM diagnosed between 1990 and 2000 were reviewed.

Results: Over a 10-year period, the number of pediatric patients less than 18 years of age diagnosed with T2DM at the Montefiore Medical Center increased tenfold. At presentation, the mean age was 14 +/- 2.3 years, the mean body mass index (BMI) was 34.4 +/- 9 kg/m(2), the female/male ratio was 1.6:1, and all these patients were pubertal. Acanthosis nigricans was present in 89% of the patients, polyuria and polydipsia occurred in 48%, weight loss occurred in 22%, and nearly 30% of the patients were asymptomatic at diagnosis. Diabetic ketoacidosis occurred in 5 patients. By 5 years after diagnosis, 45% of the patients were able to maintain an HgbA1C <7% with oral medications (metformin and/or glipizide); 18% required insulin (<0.4 U/kg/day) in addition to oral medications, and 37% did not require any medication. The mean insulin level, BMI and HgbA1C at the time of diagnosis did not predict treatment requirements for 3 years after diagnosis.

Conclusions: Because the incidence of T2DM is increasing in adolescents, the natural history and optimal therapy for adolescents with T2DM need to be established.

MeSH terms

  • Adolescent
  • African Americans*
  • Blood Glucose / analysis
  • Body Mass Index
  • Caribbean Region / ethnology
  • Child
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / ethnology*
  • Diabetes Mellitus, Type 2 / pathology
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / metabolism
  • Hispanic Americans*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / blood
  • Insulin / therapeutic use
  • Male
  • Metformin / therapeutic use
  • Obesity
  • Prevalence

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • Metformin