OBJECTIVE: Noncommunicable diseases, including insulin resistance and type 2 diabetes mellitus (T2DM) are increasing in the pediatric population. Once considered prevalent in high-income countries, the number of T2DM cases in children are also increasing in developed countries, including Indonesia. This study aimed to describe the characteristics of children with T2DM by presenting nine cases from Cipto Mangunkusumo Hospital, a tertiary care center in Jakarta, Indonesia, and AP & AP Pediatric Clinic, Jakarta.
METHOD: A retrospective descriptive study was conducted by extracting nine patients’ data from the medical records. Type 2 DM was diagnosed based on clinical symptoms, random or fasting blood glucose, HbA1C level, and C-peptide assay.
RESULTS: Out of nine patients diagnosed with Type 2 DM, six were girls and three were boy. All patients were adolescents, the age range at first diagnosis of DM was 10-17 years. Family history of type 2 DM was present in 7 out of 9 patients. Only three patients presented with 3P classical symptoms (polyphagia, polyuria, polydipsia). One patient presented with ocular symptoms and was priory diagnosed with glaucoma. Six patients were obese. The mean HbA1c was 11.42% (SD 1.9%). Microalbuminuria was seen in three patients. Eight out of nine patients received metformin, while one patient consumed glimepiride. Additional insulin was needed for four patients.
CONCLUSION: Cases of T2DM are starting to emerge in Indonesian children, especially in obese adolescents with family history of DM. However, the results of this study may be an iceberg phenomenon because data were extracted from a tertiary care hospital and a pediatric endocrinology clinic; the real number of pediatric T2DM is expected to be higher. Screening for type 2 DM in children at risk is of importance, as well as increasing awareness in the society that T2DM not only can occur in adults, but also in children and teenagers.