Children with immune mediated T1 DM
Most common cause of DM in children and adolescents
Usually not overweight
Often have acute onset of severe symptoms associated with ketoacidosis
No clear inheritance pattern
Only 5% will have a relative with T1 DM
Characterized by the presence of autoantibodies
May have other autoimmune disorders in the family or individual
Most common in Caucasians
Rare in African American children
Children with typical T2 DM
Usually overweight
Usually present with glucose in urine without ketonuria
Symptoms usually develop gradually
Ketoacidosis is NOT commonly seen except under conditions of severe stress
May have a family history of T2 DM without a clearly dominant pattern
74-100% have 1st or 2nd degree relative with T2 DM
45-80% have at least one parent with T2 DM
Acanthosis nicgricans present in up to 90% of children with T2 DM
Polycystic ovary syndrome may co-occur with T2 DM
May also have hirsutism, virilization or oligomenorrhea
Classic MODY
T2 DM in two or more generations
One individual in family must have diagnosis of T2 DM before age 25
Usually gradual onset with mild symptoms
Less likely obese than individuals with typical T2 DM
More common in Caucasians
ADM (Atypical Diabetes Mellitus)
Family history of early onset DM (before age 40)
AD inheritance (75% of families have a multigenerational pattern)
May be insulin dependent initially
Later follows a non-insulin dependent course
Often have acute onset with severe symptoms (ketoacidosis)
More likely obese than individuals with classic MODY (~50% are obese)
More common in African Americans
Accounts for up to 10% of youth onset DM in African Americans
