<p><b>Background:
</b>Type
2 diabetes in the United States is more prevalent in youth of minority
racial-ethnic background but disparities in health outcomes have not be
examined in this population. </p>
<p><b>Methods:
</b>We
examined racial-ethnic differences in the initial presentation and subsequent comorbidities
in youth with type 2 diabetes (N=1217, 63% females) enrolled in the Pediatric Diabetes
Consortium (PDC) Registry from February 2012 to June 2018. Demographic and
clinical data were collected from medical records and participant self-report. </p>
<p><b>Results:
</b>Overall,
the mean age at presentation was 13.4 ± 2.4 years, BMI was 35.0 (9.4) kg/m<sup>2</sup>.
HbA1c was higher and C-peptide was lower in Non-Hispanic Black (NHB) and
Hispanic (H) youth compared to Non-Hispanic White (NHW) youth. NHB were 3 times
as likely to present in DKA (19%) vs. NHW (6.3%) and H (7.5%) and both NHB and
H had a worse HbA1c trajectory compared with NHW peers. Microalbuminuria was
documented in 11%, hypertension in 34% and dyslipidemia in 42% of Registry
participants with no significant difference among racial-ethnic groups.
Non-alcoholic fatty liver disease (NAFLD) was diagnosed in 9% and 11% of H and
NHW, respectively vs. 2% in NHB.</p>
<p><b>Conclusion:
</b>NHB
and H youth with type 2 diabetes presented with worse metabolic control and had
persistently worse HbA1c trajectories compared with NHW. Comorbidities exist in
a large percentage of these youth independent of race-ethnicity, except for NAFLD
being less prevalent in NHB. Greater efforts are needed to mitigate racial-ethnic
disparities at diagnosis and in the management of youth with type 2 diabetes. </p>