P-26: Clinical and metabolic characteristics at diagnosis of youth-onset type 2 diabetes in a tertiary pediatric hospital of Argentina
A Lacquaniti, L Gaete, F Miari, E Escudero, C Puma, M Balderrama, M Veizaga, C Araujo, P Palenque, A RoussosAbstract
Introduction
Type 2 diabetes (T2D) in youth has increased alongside childhood obesity. Characterizing clinical and metabolic features at diagnosis is essential to improve early detection and management, particularly in regions with limited data.
Objectives
To describe clinical presentation and baseline metabolic characteristics of youth with T2D and explore their association with markers of metabolic severity.
Methods
Retrospective study of patients <18 years diagnosed with T2D between January 2022 and May 2025 at a pediatric hospital in Buenos Aires. Clinical, anthropometric, and biochemical variables at diagnosis were analyzed. Associations between clinical features and metabolic markers were evaluated.
Results
Twenty-five patients were included (60% female), mean age 13.8±1.6 years; most were pubertal and had obesity. Presentation ranged from hyperglycemia (48%) and impaired glucose tolerance (28%) to ketosis (12%) and diabetic ketoacidosis (12%). Nearly half were symptomatic and 44% required hospitalization. Mean HbA1c was 9.3±3.3%, with C-peptide 3±1.5 ng/mL. HbA1c was inversely associated with C-peptide (p<0.05). Greater weight loss was associated with lower C-peptide and higher HbA1c, while higher BMI z-score showed the opposite pattern (p<0.05). Symptomatic patients exhibited higher glucose, higher HbA1c, and lower C-peptide (p<0.05). Markers of insulin resistance were common, including acanthosis nigricans (84%). Comorbidities were frequent, particularly hypertriglyceridemia and hepatic steatosis. Family history of obesity and T2D was highly prevalent. Patients with maternal diabetes during pregnancy had a younger age at diagnosis (p<0.05).
Conclusions
Youth-onset T2D presents with marked metabolic heterogeneity at diagnosis, combining insulin resistance with features of insulin deficiency. Clinical markers such as weight loss and symptomatology may help identify patients with greater metabolic severity. Early recognition of high-risk individuals is essential to enable timely and intensive management.