1424-P: Imprecise Diagnosis of Diabetes Type in Youth

Abstract

Identifying diabetes (DM) type at the time of onset is important to establish the correct management but is increasingly difficult due to overlaps in characteristics between the most frequent DM types. We aimed to evaluate the prevalence and characteristics of youth with imprecise DM type at onset. In a large, tertiary, USA pediatric hospital, we studied (1) 2073 youth with new onset DM (Cohort 1: median age [IQR]: 11.4 [6.2] years, 50% male, 75% White, 21% Black, 37% Hispanic) and compared characteristics of those with DM that was classified by their treating endocrinologists as “unknown type” versus others; and (2) 1019 youth followed for ≥3 years since DM diagnosis (Cohort 2: median age [IQR]: 10.7 [5.7] years, 51% male, 77% White, 19% Black, 34% Hispanic), and compared characteristics of youth whose DM type changed between diagnosis and 3 years later, versus children whose DM classification did not change. In Cohort 1, “unknown” DM type appeared in 62 youth (3%), associated with older age, negative IA-2 antibody, lower C-peptide, and absence of diabetic ketoacidosis after adjustment for confounding factors. In Cohort 2, “changed” DM type appeared in 35 youth (3.4%), and, after adjusting for confounders, was not associated with any single characteristic. Other results are summarized in Table 1. In sum, DM type at onset is unknown or changes 3 years later in 6.5% of youth with DM. These findings warrant further research to optimize DM care in youth. Disclosure M.Tosur: Advisory Panel; Provention Bio, Inc. X.C.Huang: None. A.S.Inglis: None. R.Schneider aguirre: None. M.J.Redondo: None. Funding National Institutes of Health (R01DK124395 to M.J.R.), (K23DK129821 to M.T.)