PMID- 20797726
OWN - NLM
STAT- MEDLINE
DCOM- 20110106
LR  - 20110128
IS  - 1097-6833 (Electronic)
IS  - 0022-3476 (Linking)
VI  - 158
IP  - 1
DP  - 2011 Jan
TI  - Glycemic control in youth with type 2 diabetes declines as early as two years 
      after diagnosis.
PG  - 106-11
LID - 10.1016/j.jpeds.2010.07.011 [doi]
AB  - OBJECTIVES: To determine the course of glycemic decline in a pediatric cohort 
      with type 2 diabetes mellitus (T2DM) by defining longitudinal changes in 
      hemoglobin A1c (HbA1c) and insulin requirement. We also followed markers of 
      insulin reserve (fasting C-peptide and IGFBP-1) over time. STUDY DESIGN: 
      Participants included two groups: (1) T2DM Nonacidotic (NA) (n = 46); and (2) 
      T2DM diabetic ketoacidosis (n = 13). HbA1c, insulin dose, and fasting C-peptide 
      and IGFBP-1 were obtained at baseline and every 6 months for 4 years. RESULTS: At 
      baseline, Mann Whitney tests demonstrated that the diabetic ketoacidosis group 
      had higher HbA1c (P = .002), required more insulin (P = .036), and had lower 
      C-peptide (P = .003) than the NA group. Baseline insulin dose (Spearman r = 
      -0.424, P = .009) and baseline IGFBP-1 (Spearman r = -0.349, P = .046) correlated 
      negatively with C-peptide. Over time, HbA1c, insulin dose, and C-peptide changed 
      significantly in a complex manner, with group differences. HbA1c reached a nadir 
      at 6 to 12 months and began to rise after 1.5 years. Insulin requirements reached 
      a nadir at 1 year and began to rise after 2 years. CONCLUSIONS: Unlike adults, 
      children with T2DM require increasing insulin doses over a 4-year period, and 
      diabetic ketoacidosis at diagnosis predicts greater beta-cell decline over time.
CI  - Copyright (c) 2011 Mosby, Inc. All rights reserved.
FAU - Levitt Katz, Lorraine E
AU  - Levitt Katz LE
AD  - Division of Endocrinology and Diabetes, Department of Pediatrics, The Children's 
      Hospital of Philadelphia, University of Pennsylvania School of Medicine, 
      Philadelphia, PA 19104-4399, USA. KatzL@email.chop.edu
FAU - Magge, Sheela Natesh
AU  - Magge SN
FAU - Hernandez, Marcia L
AU  - Hernandez ML
FAU - Murphy, Kathryn M
AU  - Murphy KM
FAU - McKnight, Heather M
AU  - McKnight HM
FAU - Lipman, Terri
AU  - Lipman T
LA  - eng
GR  - UL1-RR-024134/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20100825
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Adolescent
MH  - *Blood Glucose
MH  - Diabetes Mellitus, Type 2/*blood/diagnosis
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Time Factors
EDAT- 2010/08/28 06:00
MHDA- 2011/01/07 06:00
CRDT- 2010/08/28 06:00
PHST- 2009/11/24 00:00 [received]
PHST- 2010/06/17 00:00 [revised]
PHST- 2010/07/09 00:00 [accepted]
PHST- 2010/08/28 06:00 [entrez]
PHST- 2010/08/28 06:00 [pubmed]
PHST- 2011/01/07 06:00 [medline]
AID - S0022-3476(10)00589-5 [pii]
AID - 10.1016/j.jpeds.2010.07.011 [doi]
PST - ppublish
SO  - J Pediatr. 2011 Jan;158(1):106-11. doi: 10.1016/j.jpeds.2010.07.011. Epub 2010 
      Aug 25.