Data from: Clinical and metabolic characteristics among Mexican children with different types of diabetes mellitus

Background: Current classification of diabetes mellitus (DM) is based on etiology and includes type 1 (T1DM), type 2 (T2DM), gestational, and other. Clinical and pathophysiological characteristics of T1DM and T2DM in the same patient have been designated as type 1.5 DM (T1.5DM).
Objectives: The aim of this study was to classify pediatric patients with DM based on pancreatic autoimmunity and the presence or absence of overweight/obesity, and to compare the clinical, anthropometric, and biochemical characteristics between children in the different classes of DM.
Methods: A sample of 185 patients, recruited (March 2008-April 2015) as part of the Cohort of Mexican Children with DM (CMC-DM); ClinicalTrials.gov, identifier: NCT02722655. The DM classification was made considering pancreatic autoimmunity (via antibodies GAD-65, IAA, and AICA) and the presence or absence of overweight/obesity. Clinical, anthropometric and biochemical variables, grouped by type of DM were compared (Kruskal-Wallis or chi-squared test).
Results: The final analysis included 140 children; 18.57% T1ADM, 46.43% T1BDM, 12.14% T1.5DM, and 22.86% T2DM. Fasting C-Peptide (FCP), and hs-CRP levels were higher in T1.5DM and T2DM, and the greatest levels were observed in T1.5DM (p<0.001 and 0.024 respectively).
Conclusions: We clearly identified that the etiologic mechanisms of T1DM and T2DM are not mutually exclusive, and we detailed why FCP levels are not critical for the classification system of DM in children. The findings of this study suggest that T1.5DM should be considered during the classification of pediatric DM and might facilitate more tailored approaches to treatment, clinical care and follow-up.

背景：当前糖尿病（Diabetes Mellitus, DM）的分型基于病因学，涵盖1型糖尿病（Type 1 Diabetes Mellitus, T1DM）、2型糖尿病（Type 2 Diabetes Mellitus, T2DM）、妊娠糖尿病及其他类型。同一患者同时兼具1型与2型糖尿病的临床及病理生理特征者，被定义为1.5型糖尿病（Type 1.5 Diabetes Mellitus, T1.5DM）。
目的：本研究旨在基于胰腺自身免疫状态以及超重/肥胖的存在与否，对糖尿病儿科患者进行分型，并比较不同分型糖尿病患儿的临床、人体测量学及生化特征。
方法：本研究样本纳入2008年3月至2015年4月期间招募的185例患者，这些患者来自墨西哥糖尿病儿童队列（Cohort of Mexican Children with DM, CMC-DM），其临床试验注册号为ClinicalTrials.gov：NCT02722655。本研究的糖尿病分型依据胰腺自身免疫指标（包括谷氨酸脱羧酶65抗体（GAD-65）、胰岛素自身抗体（IAA）及胰岛细胞抗体（AICA））以及超重/肥胖的存在与否确定。按糖尿病分型对临床、人体测量学及生化变量进行比较，统计检验采用Kruskal-Wallis检验或卡方检验。
结果：最终纳入分析的患儿共140例，其中1A型糖尿病（T1ADM）占18.57%，1B型糖尿病（T1BDM）占46.43%，1.5型糖尿病（T1.5DM）占12.14%，2型糖尿病（T2DM）占22.86%。1.5型糖尿病及2型糖尿病患儿的空腹C肽（Fasting C-Peptide, FCP）与高敏C反应蛋白（high-sensitivity C-reactive protein, hs-CRP）水平更高，其中1.5型糖尿病患儿的上述指标水平最高（分别对应p<0.001及p=0.024）。
结论：本研究明确证实，1型糖尿病与2型糖尿病的发病机制并非互斥，并阐明了空腹C肽水平并非儿童糖尿病分型体系关键指标的原因。本研究结果提示，在儿童糖尿病分型过程中应纳入1.5型糖尿病的考量，这将有助于制定更具针对性的治疗、临床照护及随访方案。