Metabolic, immunological and clinical characteristics in newly diagnosed Asian diabetes patients aged 12-40 years

• Published in: Diabetic medicine Vol. 21; no. 9; pp. 1007 - 1013
• Main Authors: Pan, C. Y., So, W. Y., Khalid, B. A. K., Mohan, V., Thai, A. C., Zimmet, P., Cockram, C. S., Jorgensen, L. N., Yeo, J. P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.09.2004; Blackwell
• Subjects: Administration, Oral; Adolescent; Adult; Asians; autoantibodies; Biological and medical sciences; Blood Glucose - analysis; Blood Pressure - physiology; Body Mass Index; C-peptide; C-Peptide - blood; Child; China - epidemiology; diabetes mellitus; Diabetes Mellitus - ethnology; Diabetes Mellitus - immunology; Diabetes Mellitus - metabolism; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - immunology; Diabetes Mellitus, Type 2 - metabolism; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Family Health; Female; Glycated Hemoglobin A - analysis; Hong Kong - epidemiology; Humans; Hypoglycemic Agents - administration & dosage; India - epidemiology; insulin deficient; Insulin Resistance - immunology; Malaysia - epidemiology; Male; Medical sciences; Singapore - epidemiology; Endocrinopathy; Autoimmunity; Human; Pancreatic hormone; Antibody; Diabetes mellitus; Deficiency; Autoantibody; Early stage; Metabolism; Insulin; C-Peptide; insulin deficient; autoantibodies; Age; Asians
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2004.01287.x

Aim  To describe the clinical, biochemical and immunological characteristics of young‐onset diabetes in Asia. Methods  Clinical, biochemical and immunological variables were assessed in 919 newly diagnosed (duration less than 12 months) young onset Asian diabetic patients aged between 12 and 40 years. The subjects constituted 57% Chinese, 29% Indians and 14% Malays, recruited from diabetes centres in China, Hong Kong, India, Malaysia and Singapore. Results  The mean age (± sd) was 31.6 ± 7.2 years, with the majority (66%) in the 31–40 years age group. Mean body mass index (BMI) (± sd) was 25.3 ± 5.0 kg/m2 with 47% exceeding the suggested Asian cut‐off point for obesity (BMI ≥ 25). Ethnic difference in clinical characteristics included BMI, blood pressure, mode of treatment and degree of insulin resistance. Most patients had a clinical presentation of Type 2 diabetes. About 10% had a classical combination of ketotic presentation, presence of autoimmune‐markers and documented insulin deficiency indicative of Type 1 diabetes. Forty‐eight percent were receiving oral hypoglycaemic agents (OHAs) while 31% were on diet only, 18% were receiving insulin and 2% were on a combination of insulin and OHA. Conclusion  Young onset diabetes patients in Asia represent a heterogenous group in terms of their clinical and biochemical characteristics and classical Type 1 diabetes is relatively uncommon. The 5‐year follow up study will determine the progress of these patients and help to clarify the natural history.