There has been a growing recognition of type 2 diabetes in youth, particularly in minority populations. However, a case definition for surveillance of diabetes among youth does not currently exist. To develop a working case definition for surveillance of diabetes among youth, the IHS diabetes registries for 6 reservations in Montana and Wyoming were used to identify all youth under age 20 with diabetes from 1997-1999. The medical records of youth with diagnosed diabetes were reviewed (N=52) to collect clinical and treatment information at diagnosis and follow-up. Factors used to define type 2 diabetes included: weight/age >=85th percentile or Acanthosis Nigricans (AN) at diagnosis, elevated c-peptide or insulin <1 year after diagnosis, family history of type 2 diabetes, or current use of OHA +/- insulin or no treatment. Factors to define type 1 diabetes included: age <=5 years or weight/age <=15th percentile at diagnosis or a positive ICA test within <1 year after diagnosis. The frequency of documentation for the factors included: age (98%), weight (73%), AN (31%), family history of type 2 diabetes (50%), ICA (25%), insulin or c-peptide (27%), OHA (92%). Of the 52 cases, 25 (48%) were classified as type 2, 14 type 1 (27%), 3 had diabetes secondary to other conditions (6%). Ten cases (19%) could not be classified. The prevalence of type 1 was 0.6/1,000 and type 2 1.1/1,000. The working case definition based on available clinical data can be used to monitor diabetes among youth. Further study is needed to refine the surveillance definition.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1. Recognize that type 2 diabetes in youth is an emerging public health problem. 2. Identify factors used to define type 2 diabetes in youth. 3. Describe the frequency of factors of type 2 diabetes in youth
Keywords: Diabetes, American Indians
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.