179-LB: Characteristics of Children with Medication-Induced Diabetes (MID): A Canadian Pediatric Surveillance Program (CPSP) Study

Diabetes(2020)

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摘要
Objectives: There is limited data on MID in children. This study aimed to compare the demographic and clinical characteristics of 1) a historical MID cohort to a new cohort and 2) children with MID based on overweight/obese BMI (O-BMI) and normal weight BMI (N-BMI). Methods: National surveillance was conducted via the CPSP. Pediatric clinicians reported new cases (children <18 years old) of non-type 1 diabetes for 24-months (cohort 1: 2006-08, cohort 2: 2017-19). MID cases were classified by the presence of diabetes as defined by Diabetes Canada and exposure to a diabetogenic medication. Comparisons were made between the two cohorts and between MID patients with O-BMI (BMI ≥85th percentile for age and sex) and N-BMI (BMI <85th percentile for age and sex). Descriptive statistics and Fisher exact, chi-squared and t-tests were used where applicable. Results: There were 55 cases of MID in cohort 1 and 51 cases in cohort 2, with no significant differences between cohorts. Mean age (+/- SD) at presentation was 13.1 +/- 3.6 years and 13.3 +/- 3.5 years in cohort 1 and 2, respectively. Glucocorticoid therapy was documented in >95% of cases in both cohorts. In the combined cohorts there were 50 cases with N-BMI and 43 cases with O-BMI. There were no statistically significant differences in age, sex or ethnicity across BMI groups. Mean hemoglobin A1c (+/- SD) (n = 40) was 6.45% +/- 1.11% in the N-BMI group and 7.26% +/- 2.51% in the O-BMI group (p = 0.184). The O-BMI group were more likely to have a parent with type 2 diabetes (T2D) (p = 0.042) and acanthosis nigricans (p = 0.007) compared to the N-BMI group. Conclusions: The demographic and clinical features of children with MID have not changed over a 10-year period. The presence of acanthosis nigricans and/or a parent with T2D may be used to identify children who require more intensive glycemic monitoring when on a diabetogenic medication. Further studies are needed to better understand the evolution of MID and the risk it confers to developing T2D. Disclosure T.J. Patel: None. A. Ayub: None. M.A. Irvine: None. S. Hadjiyannakis: None. M. Henderson: None. M.A. Nour: None. T. Pinto: None. B. Wicklow: None. J. Hamilton: None. E. Sellers: None. S. Amed: None. Funding Diabetes Canada; Manitoba Institute for Child Health and Sick Kids Hospital; Public Health Agency of Canada (F18-02353)
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