{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:10:07Z","timestamp":1790665807694,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T00:00:00Z","timestamp":1562198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To describe the baseline clinical and laboratory findings and treatment modalities of 367 children and adolescents diagnosed with Type 2 diabetes in various paediatric endocrinology centres in Turkey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A standard questionnaire regarding clinical and laboratory characteristics at onset was uploaded to an online national database system. Data for 367 children (aged 6\u201318 years) newly diagnosed with Type 2 diabetes at 37 different paediatric endocrinology centres were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After exclusion of the children with a <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> Z\u2010score &lt; 1 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>, those with genetic syndromes associated with Type 2 diabetes, and those whose C\u2010peptide and\/or insulin levels were not available, 227 cases were included in the study. Mean age was 13.8 \u00b1 2.2 (range 6.5\u201317.8) years, with female preponderance (68%). Family history of Type 2 diabetes was positive in 86% of the children. The mean <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> was 31.3 \u00b1 6.5 kg\/m<jats:sup>2<\/jats:sup> (range 18.7\u201361) and <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> Z\u2010score was 2.4 \u00b1 0.8 (range 1\u20135). More than half (57%) of the children were identified by an opportunistic diabetes screening due to existing risk markers without typical symptoms of diabetes. Only 13% (<jats:italic>n<\/jats:italic> = 29) were treated solely by lifestyle modification, while 40.5% (<jats:italic>n<\/jats:italic> = 92) were treated with metformin, 13% (<jats:italic>n<\/jats:italic> = 30) were treated with insulin, and 33.5% (<jats:italic>n<\/jats:italic> = 76) were treated with a combination of insulin and metformin initially. Mean HbA<jats:sub>1C<\/jats:sub> levels of the insulin and combination of insulin and metformin groups were 98\u00a0(11.1%) and 102 mmol\/mol (11.5%), respectively, and also were significantly higher than the lifestyle modification only and metformin groups mean HbA<jats:sub>1C<\/jats:sub> levels (70(8.6%) and 67 mmol\/mol (8.3%), respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An opportunistic screening of children who are at high risk of Type 2 diabetes is essential, as our data showed that &gt; 50% of the children were asymptomatic at diagnosis. The other important result of our study was the high rate of exclusion from the initial registration (38%), suggesting that accurate diagnosis of Type 2 diabetes in youth is still problematic, even for paediatric endocrinologists.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14038","type":"journal-article","created":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T08:51:40Z","timestamp":1558083100000},"page":"1243-1250","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Characteristics of Turkish children with Type 2 diabetes at onset: a multicentre, cross\u2010sectional study"],"prefix":"10.1111","volume":"36","author":[{"given":"S.","family":"Hatun","sequence":"first","affiliation":[{"name":"Ko\u00e7 University School of Medicine Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3919-7763","authenticated-orcid":false,"given":"G.","family":"Yesiltepe Mutlu","sequence":"additional","affiliation":[{"name":"Ko\u00e7 University School of Medicine Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Cinaz","sequence":"additional","affiliation":[{"name":"Gazi University School of Medicine, Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Turan","sequence":"additional","affiliation":[{"name":"Marmara University School of Medicine, Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Ekberzade","sequence":"additional","affiliation":[{"name":"Marmara University School of Medicine, Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bereket","sequence":"additional","affiliation":[{"name":"Marmara University School of Medicine, Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Y.","family":"Erbas","sequence":"additional","affiliation":[{"name":"Kanuni Sultan Suleyman Training and Research Hospital Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Akcay","sequence":"additional","affiliation":[{"name":"Kanuni Sultan Suleyman Training and Research Hospital Turkey"},{"name":"Istinye University Medical Park Gaziosmanpasa Hospital Pediatric Endocrinology Unit Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Onal","sequence":"additional","affiliation":[{"name":"Kanuni Sultan Suleyman Training and Research Hospital Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bolu","sequence":"additional","affiliation":[{"name":"D\u00fczce University Faculty of Medicine, Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Arslanoglu","sequence":"additional","affiliation":[{"name":"D\u00fczce University Faculty of Medicine, Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Doger","sequence":"additional","affiliation":[{"name":"Gazi University School of Medicine, Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. A.","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"University of Health Sciences Dr. Sami Ulus Obstetrics and Gynecology Children's Health and Disease Training and Research Hospital Clinic of Pediatric Endocrinology Turkey"},{"name":"University of Health Sciences Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital Department of Pediatric Endocrinology Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Ucakturk","sequence":"additional","affiliation":[{"name":"University of Health Sciences Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital Department of Pediatric Endocrinology Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. S.","family":"Karabulut","sequence":"additional","affiliation":[{"name":"Kocaeli University Faculty of Medicine, Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. \u00dc.","family":"Tuhan","sequence":"additional","affiliation":[{"name":"Dokuz Eyl\u00fcl Faculty of Medicine Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Demir","sequence":"additional","affiliation":[{"name":"Dokuz Eyl\u00fcl Faculty of Medicine Division of Pediatric Endocrinology and Diabetes Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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