Chua Cherie, Wee Poh Hui and Vasanwala Farhad Rashida*
Department of Pediatrics, Endocrine Service, KK Women’s and Children’s Hospital, SingaporeFulltext PDF
Objectives: To assess clinical and demographic characteristics of children & adolescence diagnosed with type 2 diabetes and review their management. Methods: This is descriptive audit of data collected from diabetes database and case records of patients between January 2007 to May 2015. Patients included were aged between 10 and 18 years old at diagnosis; with at least 1-year duration of T2DM. Treatment was either single therapy with insulin or OHA, or combination therapy with both insulin and OHA. Comparison was made between patients on single vs. combination therapy (Group 1) and patients on insulin-only vs. OHA-only therapy (Group 2). Results: Of 70 subjects, 18 were started on insulin, 30 on OHA & 22 on combination therapy. In Group 1, mean HbA1c at diagnosis was significantly lower in patients on single than combination therapy [9.47 ± 3.18 vs.12.4 ± 1.42%; p<0.001], while in Group 2 it was lower in OHA than insulin therapy [7.91 ± 2.06 vs. 12.2 ± 2.95%; p<0.001]. Patients initiated on combination therapy were more likely to be younger (p=0.021) and have higher HbA1c (p<0.001) than those on single therapy. Mean weight at diagnosis was not significantly different in Group 1, but in Group 2 it was significantly higher in those on OHA than insulin [75.5 ± 21.1 vs. 55.8 ± 18.0 kg; p=0.004]. Reduction in HbA1c at one year was seen across all treatment groups, a greater reduction is seen in those on combination treatment as compared to those on insulin alone. Conclusion: Significant reduction in HbA1c is seen in all treatment groups; those started on combination therapy had greater reduction in HbA1c than those on insulin alone.
T2DM; OHA; Insulin; Single therapy; Combination therapy
Cherie C, Hui WP, Rashida VF. An Audit of Pediatric Type 2 Diabetes Management in a Single Institution. Ann Diabetes Res. 2021; 5(1): 1016..