Objectives: To assess the frequency of youth onset Type 2 diabetes mellitus (T2D) in Jamaica and the characteristics of youth with this form of diabetes.
Methods: Patients from two major referral hospitals, diagnosed with diabetes before age 25 years and < 6 years prior to the study, were evaluated. Classification was based on the presence of GAD-65 and IA-2 diabetes autoantibodies (AB), fasting (FCP) and stimulated C-peptide (SCP) measurements, serum leptin and clinical phenotype as follows: (i) Type 1A diabetes – AB+, (ii) Type 1B diabetes – AB- and FCP < 230 pmol/l and/or SCP < 660pmol/l, (iii) Type 2 diabetes – AB- and FCP > 500pmol/L and or SCP ≥ 1160 pmol/l (iv) Untypeable diabetes – AB- and FCP 230–500 pmol/l and or SCP 660–1160 pmol/l and (v) Lipoatrophic diabetes – clinical phenotype and serum leptin.
Results: Fifty-eight participants (21M, 37F, age 20 ± 8 years, duration of diabetes 2.6 ± 2 years) were enrolled in the study. Using the classification criteria, Type 1 diabetes was the most common form of diabetes: 18(31%) Type 1A, 18(31%) Type 1B. Overall 22% (13 patients) had T2D. Patients with T2D were more likely to be female, older at diagnosis, obese and have a higher blood pressure when compared to those with Type 1 diabetes. In logistic regression analysis, age of diabetes onset, gender, BMI, systolic and diastolic blood pressure were significantly associated with T2D. Obesity measured by BMI was the strongest predictor of T2D.
Conclusions: While Type 1 diabetes was the predominant form of diabetes in this study, a significant proportion of Jamaicans with youth onset diabetes may have T2D. Obesity is the strongest clinical predictor of Type 2 diabetes in the young diabetic patient.