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Clin Pediatr (Phila). 2012 Oct;51(10):939-44. doi: 10.1177/0009922812441666. Epub 2012 Apr 11.

Changing spectrum of diabetes mellitus in children: challenges with initial classification.

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1
Wayne State University, Detroit, MI, USA.

Abstract

OBJECTIVE:

To determine the frequency of initial misclassification of diabetes mellitus (DM) in children and to compare the presenting features of DM1, DM2, and the misclassified cases.

RESULTS:

A total of 206 patients fulfilled the inclusion criteria. Of them, 74.75% had DM1 and 25.25% had DM2. Ten percent of studied patients had a subsequent change in classification. The mean HbA1c of the DM2 patients, who were initially misclassified, was 13.35% (SD = 1.96). The mean HbA1c of DM2 patients with correct initial classification was 8.83% (SD = 3.01). Diabetes ketoacidosis (DKA) was seen in 59.44% of DM1 and 23.91% of DM2 patients. Of the DM2 patients who were initially misclassified, 58.82% had presented in DKA as opposed to only 6.45% of patients who were correctly classified.

CONCLUSION:

The initial classification of DM frequently requires revision (10% in this study). The misclassification is highest among DM2 patients who initially present with higher HbA1c and DKA.

PMID:
22496179
DOI:
10.1177/0009922812441666
[Indexed for MEDLINE]
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