P-388: Islet autoimmunity in overweight and obese Vietnamese children with newly diagnosed diabetes
N Thu Hà, N K Nguyen, B N Can Thi, P T Bui, T M Do Thi, K G Dang Thi, T H Dang Thi, C D VuAbstract
Introduction
The increasing prevalence of overweight and obesity in children with newly diagnosed diabetes has complicated the differentiation between type 1 and type 2 diabetes. The presence of islet autoimmunity in this population may lead to misclassification and inappropriate management.
Objectives
To determine the prevalence of islet autoimmunity and compare clinical and biochemical characteristics between autoantibody-positive and -negative patients among overweight and obese Vietnamese children with newly diagnosed diabetes.
Methods
A retrospective study included 118 overweight or obese children diagnosed with diabetes at Vietnam National Children’s Hospital between 2022 and 2025. Islet autoantibodies (GAD, IAA, IA-2, ICA, ZnT8) were measured. Patients were classified as autoantibody-positive or -negative, and clinical and biochemical features at diagnosis were compared.
Results
Among 117 patients, 37 (31.6%) were autoantibody-positive. Mean age was 140.1 ± 41.8 months, 54.2% were male, and 59.3% were obese. Mean HbA1c was 10.9 ± 2.7%, and DKA occurred in 20.6% of patients with available data. Autoantibody-positive patients were younger (127.6 ± 48.6 vs 146.0 ± 37.4 months, p=0.027) and less likely to be obese (43.2% vs 67.5%, p=0.013). HbA1c and DKA prevalence were similar between groups (p>0.05). C-peptide levels tended to be lower in autoantibody-positive patients (p=0.082).
Conclusions
A substantial proportion of overweight and obese children with newly diagnosed diabetes exhibited islet autoimmunity. Despite differences in age and BMI, clinical and biochemical features were largely comparable between autoantibody-positive and -negative patients. These findings highlight the limitation of relying solely on clinical characteristics to classify diabetes type and support the routine assessment of islet autoantibodies in this population.