الفهرس 
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Abstract
Diabetes mellitus is a common chronic disease characterized by elevated blood glucose, caused by abnormal insulin production or abnormal insulin action that leads to disordered carbohydrates, proteins and fat metabolism, this may derive from inadequate insulin secretion (in general, the basic defect in type 1 Diabetes mellitus), from inadequate insulin action, or both (in general the description of type 2 Diabetes mellitus). Until this last decade ,type 1DM was the diagnosis in subjects younger than 18 years with new onset DM , but now type 2 DM is becoming more prevalent and is coming closer to matching the incidence of type 1 DM .(Dennis M.2004 The aim of this study was to . Highlighted type 2 diabetes mellitus as current problem with rising incidence 2. Study the correlation between age of onset of diabetes, family history ,obesity< and type 2 diabetes This work was carried on 3 groups Diabetic group (group I Included (60) diabetic patients, [(24) males and (36) females] and their age was ranging between (1 – 18) years with mean (10.7 ± 4.2) years duration of diabetes was ranging between (15 days - 9 years) with mean2.16 ± 2.13) years and with variable degree of diabetic control Sub group 1-A Selected cases from the study cases depend on the criteria of type 2 diabetes include the following :1. Age of onset of diabetes after 10 years old .2. Positive family history of diabetes.3. Body mass index (BMI 85th percentile for age and sex)4. Cutaneous manifestations specially acanthosis nigricans as pathognomonicsign of type 2 diabetes. This group include 11 patients :6 females &5 malesThe diagnosis of these children was based on: American DiabeticAssociation (ADA) Guidelines, criteria for diagnosis of diabetes (2009<1. Assay of blood sugar levels both fasting (≥ 126 mg/dL) and postprandial (≥ 200 mg/dL) levels2. History and clinical examination. 3. Family history. Control group (group II): The controlled group included (32) norma children, [(20) males and (12) females] and their age was ranging between (1 – 18) years with mean (10.3 ± 4.7) years.All children of this study were subjected to:1. Full history taking with family pedigree2. Clinical examination.3. Anthropometric measurements.4. Laboratory investigations including:a) Routine investigations:• Complete blood count.• Random blood glucose.• Fasting and postprandial blood glucose.• Kidney function test• Liver function testb) Specific investigations: Estimation of hemoglobin A1C was doneto assess glycemic control.5- All diabetic children are on protocol regimen management of insulin 6- family counseling.7-Statistical analysis of data.The result of this study can be summarized as the follow:1- As regard to age of diabetic cases the age varied from (6.5 years to14.9 years) also there were (36 females and 24 males)2-the duration of diabetes in years ranged from (0 .03-4.29 years).3- as regard to fasting blood glucose ranged from ( 70- 184 mg/dl )4- as regard to postprandial blood glucose ranged from ( 92 – 378 mg/dl)5- As regard to Random blood glucose ranged from (95- 305) mg/dl.6- HbA1C ranged from (3.41- 9.41) <>7- Serum urea ranged from (23- 43) mg/dl.8- Serum creatinine was 0.62 md/dl.9) regarding to glycosolated hemoglobin(HbA1C) as follow up marker ofdiabetic patients:At three months follow up HbA1C of diabetic patients:• Sixteen patients are tightly control (26.7) where HbA1c is ranging between(4.1-7.99) percent.• Seventeen patients are good control (28.3%) and HbA1c is ranging between (8-10) percent.• seventeen patients are fair control(28.and HbA1c is ranging between(10-12)%. This can be explained by recurrent infections.• Ten patients (16.7%) are poorly controlled where the HbA1c is more than12% .At six months follow up HbA1C of diabetic patients:• Thirteen patients are tightly control having HbA1C less than 8 percent.• Twenty one patients are good control and having HbA1C ranging between8-10 percent.Eighteen patients are fair control and having HbA1C ranging between 10-12 percent. this can be explained by recurrent infections• Eight patients are poorly control and having HbA1C more than 12 percent.At six months follow, The numbers of poorly control diabetic patientsincreased from (10) to (12) patients .10- As regard (subgroup 1-A )showing criteria suggesting type 2<diabetes >Number of patients at age of onset of diabetes above 10 years are (11)<patients (18.3 %). Among the (11) patients there is : Number of females (6) patients (54.5 %) .Number of males (5) patients (45 %). Females :males ratio (54.5 % :45.5 % ). Patients with Positive consanguinity (3) patients (27.2 %).
Patients with Positive family history (7) patients (63.6 %).
Number of obese patients ; Overweight 85th percentile for
age and sex) was (6) patients (54.5 %) . systolic blood pressure >95th percentile.(3) patients (27.27 %).<Presence of cutaneous manifestations (acanthosis nigricans ) (2)<patient (18.18%).