Trends of childhood diabetes in Southern Thailand: 20-year experience in a tertiary medical center

The incidence and/or prevalence of both childhood diabetes and the percent of type 2 diabetes mellitus (T2DM) cases in children and young adolescents have been increasing worldwide. This study aimed to examine the 20-year trends of childhood diabetes in a single tertiary medical center in Southern Thailand. The medical records of pediatric diabetic patients, aged 0-15 years, diagnosed at Songklanagarind Hospital from 1995 to 2014 were retrospectively reviewed. During the 20-year period, 156 children were diagnosed with DM: 99 (63.4%) with T1DM, 43 (27.6%) with T2DM, 2 (1.3%) with neonatal diabetes, and 12 (7.7%) with secondary diabetes. The estimated incidence of new patients with diabetes per 100 000 per year doubled from 0.12 in 1995-2000, to 0.24-0.28 in 2001-2004, and further increased to 0.39-0.48 in 2005-2012 and 0.59-0.64 in 2013-2014; and also the proportion of T2DM cases increased from 10%-15% during 1995-2003 to 25%-30% during 2004-2008, and 35%-40% during 2009-2014. At the time of diagnosis, the fasting plasma glucose and glycated hemoglobin levels were significantly greater in T1DM than T2DM patients while the lipid profiles were more abnormal in T2DM than T1DM patients. The estimated incidences of both T1DM and T2DM in pediatric patients have increased markedly over the 20-year period, and also the percentage of T2DM cases, from 10%-15% in 1995 to 35%-40% in 2014.