Risk Factors for Medication-Induced Diabetes and Type 2 Diabetes

• Published in: The Journal of pediatrics Vol. 159; no. 2; pp. 291 - 296
• Main Authors: Amed, Shazhan, MD, Dean, Heather, MD, Sellers, Elizabeth A.C., MD, Panagiotopoulos, Constadina, MD, Shah, Baiju R., MD, Booth, Gillian L., MD, Laubscher, Tessa A., MbCHB, Dannenbaum, David, MD, Hadjiyannakis, Stasia, MD, Hamilton, Jill K., MD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01.08.2011; Mosby, Inc; Elsevier
• Subjects: Acanthosis Nigricans - drug therapy; Acanthosis Nigricans - epidemiology; Adolescent; alanine transaminase; animal ovaries; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Biological and medical sciences; Canada - epidemiology; Child; children; clinical examination; Comorbidity; Diabetes Mellitus, Type 2 - chemically induced; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Dyslipidemias - drug therapy; Dyslipidemias - epidemiology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; General aspects; Glucocorticoids - adverse effects; Glucocorticoids - therapeutic use; guidelines; Humans; hyperlipidemia; hypertension; Hypertension - drug therapy; Hypertension - epidemiology; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Incidence; Male; Medical sciences; monitoring; nationalities and ethnic groups; noninsulin-dependent diabetes mellitus; obesity; Obesity - drug therapy; Obesity - epidemiology; observational studies; Pediatrics; polycystic ovary syndrome; Population Surveillance; Public health. Hygiene; Public health. Hygiene-occupational medicine; regression analysis; Retrospective Studies; risk; Risk Assessment - methods; Risk Factors; screening; Canada; ALL; Body mass index; CDA; Acute lymphoblastic leukemia; Canadian Diabetes Association; BMI; Endocrinopathy; Type 2 diabetes; Drug; Pediatrics; Chemotherapy; Treatment; Risk factor; Metabolic diseases; Epidemiology
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2011.01.017

Objective To compare the prevalence of risk factors in children aged <18 years diagnosed with medication-induced diabetes mellitus versus those diagnosed with type 2 diabetes. Study design This retrospective observational study used data from a Canadian prospective surveillance study in which clinical features of new cases of type 2 diabetes (n = 225) and medication-induced diabetes (n = 58) were reported over a 2-year period. The presence of risk factors for type 2 diabetes (eg, obesity, family history of type 2 diabetes, ethnicity, acanthosis nigricans, hypertension, polycystic ovarian syndrome) was compared in the 2 groups using descriptive statistics and logistic regression. Results Compared with the children with type 2 diabetes, the children with medication-induced diabetes were more likely to be Caucasian ( P < .0001) and less likely to be obese ( P < .0001), to have a positive family history of type 2 diabetes ( P = .0001), to have acanthosis nigricans ( P < .0001) on clinical examination, and to have an obesity-related comorbidity, such as polycystic ovarian syndrome ( P = .04), dyslipidemia ( P = .02), hypertension ( P = .04), or an elevated alanine aminotransferase level ( P = .05). Conclusions Evaluating for the typical risk factors for type 2 diabetes is not sufficient to identify all children at risk for developing medication-induced diabetes. Further studies are needed to help inform guidelines on screening for and prevention of medication-induced diabetes in children.