Title: Type 2 Diabetes in Children and Young Adults: A “New Epidemic” | Clinical Diabetes
Headings: Type 2 Diabetes in Children and Young Adults: A “New Epidemic”
Type 2 Diabetes in Children and Young Adults: A “New Epidemic”
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Content: As found in the adult population, type 2 diabetes in children and young adults is due to the combination of insulin resistance and relative b-cell failure. While there appears to be a host of potential genetic and environmental risk factors for insulin resistance and limited b-cell reserve, perhaps the most significant risk factor is obesity. Most children who develop type 2 diabetes have a family member with type 2 diabetes; 45–80% have a parent with type 2 diabetes, and 74–90% report at least one affected first- or second-degree relative. Up to 60–90% of youth who develop diabetes have acanthosis nigricans, a thickening and hyperpigmentation of the skin at the neck and flexural areas that is due to insulin resistance. More children and young adults with diabetes have this skin problem than do adults with diabetes. It is so common that it can be used as a marker of youth at risk for type 2 diabetes. Other risk factors include puberty, intrauterine exposure to diabetes, sedentary lifestyle, and female sex. Despite this increasing incidence and prevalence, little is known about the most effective treatment regimens, the roles of physical activity and nutrition counseling in improving glycemic outcomes, and the most effective ways to reduce cardiovascular risk in these patients. Fewer than 10% of youth with type 2 diabetes are treated with diet and exercise alone.