Dear Editor

We read with interest Ehtisham and colleagues’ study [1] describing the prevalence of type 2 diabetes (T2D) and MODY in the UK paediatric clinic population.

We noted in particular their finding of an excess of T2D in patients of south Asian ethnic origin (32%) compared to other children. This is in agreement with our recently published findings of a similar excess of Asians (40% aged 10-19 years) in our Leeds population, describing the prevalence of all forms of diabetes, including T2D.[2] The data were based on all children and young adults currently aged 30 years and under attending a diabetes clinic within the metropolitan city of Leeds.

Although we only described details of five patients in Leeds with T2D aged under 20, it was the first UK study investigating this type of diabetes in children and young adults, where we also found a strong independent association between the occurrence of T2D and socio-economic status, after allowing for ethnic group. It is also vital to put into context the impact of T2D in relation to other forms of the disease, as Ehtisham et al do. We feel it is important therefore that both studies are considered in parallel, providing a basis from which to monitor the burden of disease within children, teenagers and young adults with diabetes, a unique group with particular social and emotional needs. It is equally important that the key message from both studies showing an emergence of T2D in young people, coinciding with increasing levels of obesity and an excess in Asians, is appreciated by clinical decision makers in the UK and other westernised societies.

From an editorial point of view, it was perhaps unfortunate the authors of the current study were not presented with our findings whilst our paper was awaiting publication. Of more importance, however, is for further immediate research examining the different roles of exercise, diet, ethnic group and socio-economic status and their impact on the development of T2D in children and young people.

References

1. Ehtisham S, Hattersley AT, Dunger DB, Barratt TG, for the British Society for Paediatric Endocrinology and Diabetes Clinical Trials Group. First UK survey of paediatric type 2 diabetes and MODY. Arch Dis Child 2004; 89: 526-529.

2. Feltbower RG, McKinney PA, Campbell FC, Stephenson CR, Bodansky HJ. Type 2 and other forms of diabetes in 0-30 year olds: a hospital- based study in Leeds. Arch Dis Child 2003; 88: 676-679.