HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Rotteveel, J. Articles by Delemarre-Van de Waal, H. A Search for Related Content PubMed PubMed Citation Articles by Rotteveel, J. Articles by Delemarre-Van de Waal, H. A

Type 2 diabetes in children in the Netherlands: the need for diagnostic protocols

Department of Pediatrics, Institute for Clinical and Experimental Neurosciences (ICEN), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands, ¹ Department of Pediatrics, VU Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands, ² Department of Public and Occupational Health, Institute for Research in Extramural Medicine, VU Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands, ³ TNO Quality of Life, PO Box 2215, 2301 CE Leiden, The Netherlands and ⁴ Department of Pediatrics, Institute for Clinical and Experimental Neurosciences (ICEN), VU University Medical Center, Amsterdam, The Netherlands

(Correspondence should be addressed to J Rotteveel; Email: j.rotteveel{at}vumc.nl)

Objective: The worldwide trend towards obesity in childhood is also observed in the Netherlands and one of the consequences may be type 2 diabetes. In this study, we assessed the number of children with type 2 diabetes, diagnosed by paediatricians, in the Netherlands.

Methods: In 2003 and 2004 the Dutch Paediatric Surveillance Unit, a nationwide paediatric register, was used to assess new cases of diabetes mellitus. Data on socio-demographic and clinical characteristics were collected by means of a questionnaire. A second questionnaire was sent to the reporting paediatrician if the diagnosis was inconclusive or if the diagnosis was type 1 diabetes in combination with overweight or obesity, according to international criteria.

Results: During the 24 months of registration, the paediatricians reported 1142 new cases of diabetes, 943 of which were eligible for analysis. Initially, 14 patients (1.5%) were reported with type 2 diabetes. Only seven of these patients were classified as type 2 diabetes according to the ADA criteria, as information on C-peptides or antibodies was often missing. Based on clinical characteristics, the other seven patients were very likely to have type 2 diabetes. After the second questionnaire, six more patients met the ADA criteria and two were very likely to have type 2 diabetes. Most of the patients were female (95%), 14% were of Turkish and 18% of Moroccan origin.

Conclusion: This study shows a discrepancy between the number of patients with type 2 diabetes diagnosed by paediatricians in daily practice and diagnosed according to the ADA criteria. Moreover, a considerable amount of reported patients were misclassified. Finally, 2.4% patients were classified as (very likely) type 2 diabetes. The development of programmes and protocols for prevention, diagnosis and classification applicable in daily practice is warranted.