Type 2 diabetes mellitus in the child and adolescent

Kong, .90% of young-onset diabetes is T2DM (10), in Taiwan 50% (11), and nearly 60% in Japan (Ogawa et al. personal communication). d in .75% of cases in youth in the USA in association with a first-or second-degree family history for T2DM. d in youth in the USA and Europe with body mass index (BMI) above 85th percentile for age and sex. In Japan, however, 30% of T2DM are not obese (17); in Asian Indian urban children, half of those with T2DM had normal weight (,120% ideal for height) (12); and half of Taiwanese children with T2DM were not obese (11). d in some asymptomatic individuals in high-risk populations during medical, school, or sports examinations (22, 23). d in the presence of ketosis/ketoacidosis, one third or more of newly diagnosed patients ( This presentation is responsible for misclassification of T2DM patients as having T1DM. d occasionally with severe dehydration (hyperosmolar hyperglycemic coma and hypokalemia) at presentation, which can be fatal (24, 25). d with a sex ratio (male:female) that varies from 1:4-6 in native North Americans to 1:1 in Asians and Libyan Arabs. d without associated human leukocyte antigen (HLA) specificities. d without associated islet cell autoimmunity (see autoimmune T2DM).