Copyright ©The Author(s) 2021.
World J Diabetes. Apr 15, 2021; 12(4): 344-365
Published online Apr 15, 2021. doi: 10.4239/wjd.v12.i4.344
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
PrevalenceCommon, increasingRare, increasingRare, stable
EthnicityMainly CaucasianMainly minority groupsAll
InheritanceMultigenicMultigenicAutosomal dominant
Family history5%-10% positive for T1DM75%-90% positive for T2DM100% positive for MODY
SexMale = FemaleMale < FemaleMale = Female
Age at presentationChildhood-adolescenceAdolescence Before 25 yr of age
Body habitusUsually normal weightMostly obeseVarious
Acanthosis nigricansRareVery commonAbsent
OnsetUsually acute, severeUsually insidious, rarely acuteInsidious
Ketosis at onsetCommon5%-10%Rare
Insulin, C-peptideDecreased or absentVariableDetectable
Insulin sensitivityNormal DecreasedNormal
HLA-DR3/4 associationStrong NoneNone
Pancreatic autoantibodies85%-100%< 10%Rare
Insulin dependencePermanentVariableRare
Associated disordersAutoimmune 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.
Table 2 Routine monitoring of children and adolescents with type 2 diabetes for comorbidities and chronic complications
Test performed
Testing frequency
HypertensionBP measurement with appropriately-sized cuffAt the time of diagnosis and at each routine visit; more frequently if elevated
DyslipidemiaNon-fasting or fasting lipid panelAt diagnosis once glycemic control is achieved. Annually thereafter, more frequently if abnormal
NAFLDLiver transaminasesAt diagnosis and annually thereafter
RetinopathyDilated eye examination or retinal imagingAt diagnosis and annually thereafter, or as per ophthalmologist’s advice
NephropathyIn a spot specimen urine albumin-to-creatinine ratioRepeat annually. If abnormal, repeat on at least two occasions during the next 3-6 mo
NeuropathyFoot examination (pulses and ankle reflex); sensory testing for vibration (tuning fork) and sensation (10-g monofilament)Repeat annually. If abnormal, refer to neurologist
Psychosocial assessmentScreen for depression, eating disorders, risk-taking behaviors, or other psychosocial dysfunctionRepeat at each routine visit or as needed. If abnormal, refer to mental health professionals