Characterization and identification of atypical diabetes in pediatric patients

The aim of this thesis was to better characterize drug-induced diabetes and monogenic diabetes in pediatrics, as both are currently understudied and misdiagnosed. We first identified children with acute lymphoblastic leukemia at risk of hyperglycemia (HG) by considering overweight, puberty, steroid-resistant disease, and stem cells transplantation as risk factors. Secondly, we showed that children undergoing liver or renal transplantation were more at risk of HG when they required glucocorticoids or had complications such as graft rejection or infection. Also, we highlighted that HG occurred systematically in the afternoon and was characterized by insulin resistance detected only by the oral glucose tolerance test. Finally, we demonstrated the efficacy of our new score in detecting monogenic diabetes, and introduced new clinical features to help clinicians identify atypical forms of diabetes: C-peptide secretion and the IDAA1C and GTAA1C scores.