Risk Factors for Medication-Induced Diabetes and Type 2 Diabetes
ABSTRACT 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.
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.
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).
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.
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ABSTRACT: Medication induced diabetes (MID) during induction therapy (MIDi) in patients with acute lymphoblastic leukemia (ALL) is not well characterized in children, with recent studies yielding conflicting results. The purpose of the study was to describe the prevalence of MIDi and risk factors for its development. We retrospectively gathered demographic, disease course and treatment data on 363 patients aged 1 to 17.9 years diagnosed with ALL at a pediatric tertiary care hospital between 1998 and 2005. MIDi was defined as blood glucose ≥200 mg/dL (11.1 mmol/L) on at least 2 separate days during induction. Fifty-seven subjects (15.7%) developed MIDi during the study period. Patients ≥10 years were more likely to develop MIDi than those <10 years (odds ratio [OR] 9.6, 95% confidence interval [CI] 5.1-17.8). BMI percentile among those with MIDi (mean ± SD 58.2 ± 31.0) did not differ from those without MIDi (52.2 ± 32.0, P = 0.429). The presence of Trisomy 21 (OR 3.6, 95% CI 1.1-11.4, P = 0.030) and CNS involvement at diagnosis (OR 3.8, 95% CI 1.4-10.1, P = 0.009) were associated with an increased risk of MIDi. After adjustment for potential confounding variables, age ≥10 years and the presence of CNS disease at diagnosis remained significantly associated with MIDi. Older age and CNS involvement at diagnosis increase the risk of MIDi. In contrast to previous studies, higher BMI was not associated with MIDi in our population.Supportive Care in Cancer 11/2011; 20(9):2009-15. DOI:10.1007/s00520-011-1307-5 · 2.36 Impact Factor
Article: Reply.The Journal of pediatrics 11/2011; DOI:10.1016/j.jpeds.2011.10.005 · 3.79 Impact Factor
- The Journal of pediatrics 02/2012; 160(2):355; author reply 356. DOI:10.1016/j.jpeds.2011.11.001 · 3.79 Impact Factor