Etiologies, Clinical Profiles, and Treatment Outcomes in Thai Children and Adolescents With Youth‐Onset Diabetes
Pranchalee Srikanchanawat, Jeerunda Santiprabhob, Supawadee Likitmaskul, Khwanhatai Khemaprasit, Parichat Charoentawornpanich, Thanida Tangjarusritaratorn, Supitcha Patjamontri, Ornsuda Lertbannaphong, Teerarat Manpayak, Pornpimol Kiattisakthavee, Kanyarat Wongmuan, Watip TangjittipokinABSTRACT
Background
Youth‐onset diabetes is a chronic condition requiring lifelong management, and achieving optimal glycemic control remains challenging. This study aimed to delineate etiologies of youth‐onset diabetes among Thai patients. We further examined clinical characteristics, therapeutic outcomes, and factors associated with glycemic control in type 1 diabetes (T1D) and type 2 diabetes (T2D).
Methods
We conducted a prospective cross‐sectional Pediatric Diabetes Registry Project in 2 phases: initial (March 2016–August 2018) and follow‐up (March 2019–March 2020). Individuals diagnosed before age 18 years were recruited. Data on clinical profile, glycemic control, treatment, and complications were collected.
Results
Three hundred participants were recruited at baseline. The majority (77%, n = 231) had T1D, and 15.3% ( n = 46) had T2D. The mean HbA1c in T1D was 8.96% ± 1.98%, with 22.5% achieving good glycemic control. Multivariate analysis revealed that older age (OR 1.16, 95% CI 1.01–1.32, p = 0.031) and self‐monitoring of blood glucose (SMBG) ≥ 4 times/day (OR 4.85, 95% CI 1.85–12.71, p = 0.001) were positively associated with good control. Among T2D patients, mean HbA1c was 7.55% ± 2.21%, and 56.5% achieved good control. Longer disease duration (OR 0.40, 95% CI 0.21–0.74, p = 0.003) predicted suboptimal control. At follow‐up, the prevalence of diabetic nephropathy increased in T1D (from 3.4% to 5.8%) and T2D (from 9.1% to 17.4%).
Conclusions
Most T1D patients exhibited suboptimal glycemic control, while older age and frequent SMBG predicted better outcomes. In T2D, longer disease duration correlated inversely with glycemic control, highlighting the need for proactive interventions.