In terms of comorbidities, he reported, 26% had hypertension and almost 60% had dyslipidemia.
It remains to be seen whether diabetes autoimmunity will alter the clinical course of the disorder in youth with the clinical features of type 2 diabetes, Dr. Klingensmith said.
When it comes to the risk of conditions and complications traditionally associated with type 1 diabetes, it very well may, Dr. Libman warned.
Current guidelines, for instance, recommend screening for autoimmune thyroid disease in children with type 1 diabetes who, in contrast to those with type 2 diabetes, are known to have an increased frequency of thyroid antibodies and thyroid dysfunction. But a look at a sample of children in the Pittsburgh registries shows that children with “double” diabetes may have the same prevalence of thyroid antibodies as do those with type 1 diabetes.
Twenty percent of 24 children with double diabetes (defined here as obese with diabetes antibodies) were positive for thyroid antibodies, as were 21% of 117 children with type 1 diabetes (lean with diabetes antibodies). The two groups had a similar incidence of hypothyroidism. A sample of 21 children with type 2 diabetes (obese with no diabetes antibodies) had neither problem, Dr. Libman reported.