Diagnosis, treatment and prevention of type 2 diabetes mellitus in children and adolescents

Table 1 Clinical and laboratory findings of type 1 and type 2 diabetes mellitus and maturity-onset diabetes of the young in children and adolescents

Parameter	T1DM	T2DM	MODY
Prevalence	Common, increasing	Rare, increasing	Rare, stable
Ethnicity	Mainly Caucasian	Mainly minority groups	All
Inheritance	Multigenic	Multigenic	Autosomal dominant
Family history	5%-10% positive for T1DM	75%-90% positive for T2DM	100% positive for MODY
Sex	Male = Female	Male < Female	Male = Female
Age at presentation	Childhood-adolescence	Adolescence	Before 25 yr of age
Body habitus	Usually normal weight	Mostly obese	Various
Acanthosis nigricans	Rare	Very common	Absent
Onset	Usually acute, severe	Usually insidious, rarely acute	Insidious
Ketosis at onset	Common	5%-10%	Rare
Insulin, C-peptide	Decreased or absent	Variable	Detectable
Insulin sensitivity	Normal	Decreased	Normal
HLA-DR3/4 association	Strong	None	None
Pancreatic autoantibodies	85%-100%	< 10%	Rare
Insulin dependence	Permanent	Variable	Rare
Associated disorders	Autoimmune disorders (e.g., Hashimoto, vitiligo, celiac disease)	MetS components (e.g., lipid disorders, hypertension, PCOS, sleep apnea, etc.)	Depending on type, may present with exocrine pancreas insufficiency, urogenital malformation, etc.

HLA: Human leukocyte antigen; MetS: Metabolic syndrome; MODY: Maturity-onset diabetes of the young; PCOS: polycystic ovary syndrome, T1DM: Type 1 diabetes mellitus; T2DM: Type 2 diabetes mellitus.