Journal of the Korean Pediatric Society 2000;43(12):1591-1598.
Published online December 15, 2000.
The Clinical Types and Characteristics of Diabetes Mellitus in Korean Children
Eun Gyong Yoo, Hye Jung Shin, Duk Hi Kim
Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
소아연령에서 발병된 당뇨병의 병형 및 특성
유은경, 신혜정, 김덕희
연세대학교 의과대학 소아과학교실
Abstract
Purpose
: Diabetic children should be classified into type 1 or 2 for adequate diabetic control. However, there is a shortage of information of the appropriate criteria in Korea. This study is desinged to discover the clinical types and characteristics of diabetes mellitus(DM) in Korean children.
Methods
: We studied the clinical characteristics and laboratory findings of 177 diabetic children. Classification was based on the serum C-peptide levels, presence of ketoacidosis, autoantibodies, and insulin dependence.
Results
: Among 177 diabetic children, 147(83.1%) were classified as type 1 and 21(11.9%) as type 2, and 12(57.1%) children in type 2 were obese. All patients with age of onset before 9 were type 1. In cases of type 1, initial serum C-peptide levels were <0.6(50%), 0.6-1.0(44%) and >1.0ng/mL (6%). All patients with initial serum C-peptide level above 1.5ng/mL were type 2. Four patients initially diagnosed as type 2 DM changed to type 1 during follow-up, and 2 patients of type 1 DM changed to type 2. Only 55.4% of type 1 DM patients had insulin autoantibody, islet cell cytoplasmic antibody or anti-glutamic acid decarboxylase antibodies.
Conclusion
: Most diabetic children in Korea were classified as type 1. Our results suggest that insulin requiring lean patients with positive autoantibody should be classified as type 1 even if their serum C-peptide levels are within normal range, and the clinical types could be changed during follow-up in a small proportion of diabetic children.
Key Words: Diabetes mellitus, Classification, Type 1, Type 2, C-peptide


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