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Observational Study
. 2022 Sep;23(6):649-659.
doi: 10.1111/pedi.13351. Epub 2022 Jun 1.

Youth-onset type 2 diabetes in Israel: A national cohort

Nehama Zuckerman Levin  1   2 , Meidan Cohen  1   2 , Moshe Phillip  3   4 , Ariel Tenenbaum  3   4 , Ilana Koren  2   5 , Yardena Tenenbaum-Rakover  2   6 , Osnat Admoni  6 , Eli Hershkovitz  7   8 , Alon Haim  7   8 , Kineret Mazor Aronovitch  4   9   10 , David Zangen  11   12 , David Strich  12   13   14 , Avivit Brener  4   15 , Yonatan Yeshayahu  8   16 , Yossi Schon  17 , Marianna Rachmiel  4   17 , Tal Ben-Ari  4   18 , Floris Levy-Khademi  12   14 , Rami Tibi  1   2 , Ram Weiss  1   2 , Yael Lebenthal  4   15 , Orit Pinhas-Hamiel  4   9   10 , Naim Shehadeh  1   2
Affiliations
Observational Study

Youth-onset type 2 diabetes in Israel: A national cohort

Nehama Zuckerman Levin et al. Pediatr Diabetes. 2022 Sep.

Abstract

Background: Prevalence of youth-onset type 2 diabetes (T2D) has increased worldwide, paralleling the rise in pediatric obesity. Occurrence and clinical manifestations vary regionally and demographically.

Objectives: We assessed the incidence, and clinical and demographic manifestations of youth-onset T2D in Israel.

Methods: In a national observational study, demographic, clinical, and laboratory data were collected from the medical records of children and adolescents, aged 10-18 years, diagnosed with T2D between the years 2008 and 2019.

Results: The incidence of youth-onset T2D in Israel increased significantly from 0.63/100,000 in 2008 to 3.41/100,000 in 2019. The study cohort comprised 379 individuals (228 girls [59.7%], 221 Jews [58.3%], mean age 14.7 ± 1.9 years); 73.1% had a positive family history of T2D. Mean body mass index (BMI) z-score was 1.96 ± 0.7, higher in Jews than Arabs. High systolic (≥ 130 mmHg) and diastolic blood pressure (≥ 85 mmHg) were observed in 33.7% and 7.8% of patients, respectively; mean glycosylated hemoglobin (A1c) level at diagnosis was 8.8 ± 2.5%. Dyslipidemia, with high triglyceride (>150 mg/dl) and low HDL-c (<40 mg/dl) levels, was found in 45.6% and 56.5%, respectively. Microalbuminuria and retinopathy were documented at diagnosis, 15.2% and 1.9%, respectively) and increased (36.7% and 4.6%, respectively) at follow-up of 2.9 ± 2.1 years. Criteria of metabolic syndrome were met by 224 (62.2%) patients, and fatty liver documented in 65%, mainly Jews. Psychosocial comorbidity was found in 31%. Treatment with metformin (45.6%), insulin (20.6%), and lifestyle modification (18%) improved glycemic control.

Conclusion: Youth-onset T2D in Israel has increased significantly and presents a unique profile.

Keywords: children and adolescents; ethnicity; metabolic syndrome; obesity; youth-onset type 2 diabetes.

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References

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