Pancreatic transplantation: Brief review of the current evidence

Table 1 Comparison of criteria of type 1 and type 2 diabetes mellitus[4]

	Type 1 diabetes	Type 2 diabetes
Prevalence	Common, increasing	Increasing
Age at presentation	Throughout childhood	Puberty
Onset	Typically, acute severe	Insidious to severe
Ketosis at onset	Common	5% to 10%1
Affected relative	5% to 10%	75% to 90%
Female: male	1:1	Approximately 2:1
Inheritance	Polygenic	Polygenic
HLA-DR3/4	Strong association	No association
Ethnicity	Most common in non- Hispanic white	All2
Insulin secretion	Decreased/absent	Variable
Insulin sensitivity	Normal when controlled	Decreased
Insulin dependence	Permanent	Variable
Obese or overweight	20% to 25% overweight3	> 80% obese
Acanthosis nigricans	12%4	50% to 90%4
Pancreatic antibodies	Yes5	No6

¹Reported frequency of ketonuria or ketoacidosis at time of diagnosis of type 2 diabetes mellitus (T2DM) varies widely.

²In North America, T2DM predominates in native America, African-American, Hispanic, Canadian First Nation, Pacific Islander, and Asian-American youth.

³With increased prevalence of childhood overweight, 20% to 25% of newly diagnosed with type 1 diabetes mellitus (T1DM) are overweight, which is higher than the prevalence of overweight in a similar population without T1DM. However, the prevalence of obesity is not increased among children and adolescents with T1DM. Recent weigh loss is common at presentation of children with T1DM, including among those who are overweight or obsess.

⁴These frequencies of acanthosis nigricans are based on a registry study in the United States. Populations with lower rates of obesity or difference ethnic mixes may have different results.

⁵Autoantibodies to insulin (IAA), islet cell cytoplasm (ICA), glutamic acid decarboxylase (GAD), tyrosine phosphatase (insulinoma associated) antibody (IA-2 and IA-2β), or zine channel antibody (ZnT8) are present at diagnosis in 85% to 89% of patients with T1DM.

⁶One study reported that 9.8% of youth with phenotypic T2DM have pancreatic antibodies to IA-2 and/or GAD. HLA: Human leukocyte antigen.