Demographic and clinical characteristics of a population-based paediatric cohort of type 1 and type 2 diabetes in Western Australia (1999-2019)

OBJECTIVES: To determine demographic and clinical characteristics of youth diagnosed with type 1 (T1D) or type 2 (T2D) diabetes aged ≤15 years from 1999-2019 in Western Australia, and examine time to first diagnosis of diabetes complications.

METHODS: A retrospective cohort study was conducted of patients identified from the population-based, prospective Western Australian Children's Diabetes Database and longitudinal data extracted for available demographic and clinical variables. Patients were followed from diagnosis to transition to adult services, death or 31st December 2019. Cox proportional hazards regression models were used to analyse time to first diagnosis of hypertension, high cholesterol or microalbuminuria, after adjusting for sex, age at diagnosis, time period of diagnosis, haemoglobin A1c and body max index Z-score.

RESULTS: 2,438 eligible patients were identified (2,209 (91%) T1D: 229 (9%) T2D). The mean age at diagnosis was lower in patients with T1D (8.5(±4.0) vs 12.7(±2.0) years). A higher proportion of patients with T2D were female (58% vs 47%) and of Aboriginal ethnicity (59% vs 2%). The median HbA1c [IQR] at diagnosis was lower (8.9%[6.7,11.5](74mmol/mol[50,102]) vs 11.6%[10.1,13.3](103 mmol/mol[87,122])) and mean body max index Z-score higher (2.05(±0.66) vs 0.37(±0.95)), in patients with T2D compared to T1D. Patients with T2D had a higher risk of hypertension, high cholesterol and microalbuminuria (aHR 3.39(95%CI:2.04,5.63), 2.69(95%CI:1.21,5.98) and 19.79(95%CI:10.99, 35.64) respectively).

CONCLUSION: Distinct demographic and clinical characteristics continue to be observed in this contemporary population-based cohort of paediatric patients diagnosed with T1D and T2D. Youth with T2D have significantly higher risk of diabetes complications within five years of diagnosis. This article is protected by copyright. All rights reserved.