Reclassification of diabetes type in pediatric patients initially classified as type 2 diabetes mellitus: 15 years follow-up using routine data from the German/Austrian DPV database

ObjectiveTo examine change of diagnosis in patients from the German/Austrian multicenter DPV (Diabetes Patienten Verlaufsdokumentation) database initially classified as type 2 diabetes.MethodsPatients aged ≤20 years at onset, diagnosed between 1995 and 2010 were followed for at least 6 months. Chi-square/Wilcoxon tests were performed to compare patient groups according to diabetes type after reclassification.ResultsFrom 580 study patients, 60 (10.3%) were reclassified, on average 2.4 years after initial diagnosis as follows: 23 (38.3%) as type 1 diabetes; 9 (15%) as maturity onset diabetes of the young (MODY); 20 (33.3%) as “other specific diabetes forms” and 8 (13.3%) as “remission” of type 2 diabetes. Patients reclassified to type 1 were significantly younger (13.5 ± 2.9 versus 14.0 ± 2.6; p = 0.027) and more often β-cell antibody positive at disease onset (80.0% versus 31.2%; p = 0.002), while patients reclassified as MODY had significantly lower BMI-SDS values than 520 patients with confirmed type 2 diabetes (2.5 ± 1.1 versus 0.9 ± 1.1; p < 0.001). The latter were also considerably more obese than patients in “remission” and those reclassified to “other specific diabetes forms”.ConclusionAbout 10% of patients in the DPV database, initially diagnosed as type 2 diabetes, were retrospectively reclassified.