Annals of pediatric endocrinology & metabolism · 2026
Clinical Characteristics and Temporal Trends of Pediatric Diabetes Subtypes Over 20 Years in a Tertiary Center in Korea.
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Song Ui Sook, Lee Yun Jeong, Shin Choong Ho, Lee Young Ah
Аннотация
PURPOSE: Differentiating diabetes subtypes is essential for long-term management; however, overlapping features among type 1 diabetes (T1D), type 2 diabetes (T2D), and maturity-onset diabetes of the young (MODY) complicate diagnosis. Clinical characteristics and temporal trends according to childhood-onset diabetes subtype were investigated over a 20-year period.
METHODS: We retrospectively reviewed 662 patients diagnosed with T1D, T2D, or MODY at Seoul National University Children's Hospital between 2003 and 2022 at ages ≥6 months and <19 years, excluding secondary and other specific forms. Subtypes were classified based on autoantibody status, insulin dependence, adiposity, family history, and genetic testing.
RESULTS: Of patients, 477 (72.1%) had T1D, 143 (21.6%) had T2D, and 39 (5.9%) had MODY; 3 had coexisting T1D and MODY. Ten patients underwent diabetes subtype reclassification during follow-up. T1D was associated with more frequent diabetic ketoacidosis (DKA) and less family history than T2D or MODY (both P < 0.001). T2D showed higher BMI z-scores and a greater prevalence of overweight and obesity (both P < 0.001). The proportion of T2D increased over time (P for trend < 0.001), whereas MODY remained stable (P for trend = 0.116). Among 21 genetically confirmed MODY cases, GCK variants were the most common, followed by HNF1A variants.
CONCLUSION: Over the 20-year study period, the proportion of T2D increased among children and adolescents. Expanded insurance coverage for autoantibody testing, along with more affordable access to next-generation sequencing (NGS) panels when clinically indicated, may facilitate earlier and more accurate diagnosis and enable individualized treatment.
METHODS: We retrospectively reviewed 662 patients diagnosed with T1D, T2D, or MODY at Seoul National University Children's Hospital between 2003 and 2022 at ages ≥6 months and <19 years, excluding secondary and other specific forms. Subtypes were classified based on autoantibody status, insulin dependence, adiposity, family history, and genetic testing.
RESULTS: Of patients, 477 (72.1%) had T1D, 143 (21.6%) had T2D, and 39 (5.9%) had MODY; 3 had coexisting T1D and MODY. Ten patients underwent diabetes subtype reclassification during follow-up. T1D was associated with more frequent diabetic ketoacidosis (DKA) and less family history than T2D or MODY (both P < 0.001). T2D showed higher BMI z-scores and a greater prevalence of overweight and obesity (both P < 0.001). The proportion of T2D increased over time (P for trend < 0.001), whereas MODY remained stable (P for trend = 0.116). Among 21 genetically confirmed MODY cases, GCK variants were the most common, followed by HNF1A variants.
CONCLUSION: Over the 20-year study period, the proportion of T2D increased among children and adolescents. Expanded insurance coverage for autoantibody testing, along with more affordable access to next-generation sequencing (NGS) panels when clinically indicated, may facilitate earlier and more accurate diagnosis and enable individualized treatment.