Type 2 Diabetes in Youth: Epidemiology and Pathophysiology
Ebe D’Adamo,Sonia Caprio +1 more
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TLDR
The pathophysiology of type 2 diabetes and the natural history of this pathology in obese children and adolescents is explored, which is associated with an increased lipid accumulation in visceral compartments, liver and muscle tissues and by reduced sensitivity of I²-cell of first and second-phase insulin secretion.Abstract:
The prevalence of type 2 diabetes is significantly increased in the pediatric population, which is affected by obesity worldwide. The progression from normal glucose tolerance (NGT) to type 2 diabetes involves intermediate stages of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), also known as prediabetes. The pathophysiology underlying the development of these glucose metabolic alterations is multifactorial; however an alteration in the balance between insulin sensitivity and insulin secretion represents the most important player in the development of type 2 diabetes. Obese children and adolescents affected by IGT and type 2 diabetes are characterized by severe insulin resistance, which is associated with an increased lipid accumulation in visceral compartments, liver and muscle tissues and by reduced sensitivity of I²-cell of first and second-phase insulin secretion.
The progression in obese children of insulin resistance to type 2 diabetes has been shown to be faster than in adults; in addition, type 2 diabetes is already associated with several metabolic and cardiovascular complications in this age group.
In the present review, we summarize the most recent findings concerning the prevalence of type 2 diabetes in youth and in particular we explore the pathophysiology of type 2 diabetes and the natural history of this pathology in obese children and adolescents.
Concurrent with the worldwide epidemic increase of childhood obesity, type 2 diabetes and the two prediabetic conditions, IFG and IGT, are becoming increasingly more common in obese children and adolescents (1,2). Until 10 years ago, type 2 diabetes accounted for less than 3% of all cases of new-onset diabetes in adolescents. At present 45% of cases are attributed to it (3,4).
Type 2 diabetes occurs in youth more often during the second decade of life, coinciding with the physiological occurrence of pubertal insulin resistance (1). In addition, …read more
Citations
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Vascular Complication in Adolescents With Diabetes Mellitus.
Lara E Graves,Kim C. Donaghue +1 more
TL;DR: The prevalence, risk factors, screening, and treatment recommendations for vascular complications in children and adolescents with diabetes, and some youths may be diagnosed with complications before transition to adult care are discussed.
Journal ArticleDOI
Younger-onset versus older-onset type 2 diabetes: Clinical profile and complications.
Ranjit Unnikrishnan,Ranjit Mohan Anjana,Anandakumar Amutha,Harish Ranjani,Saravanan Jebarani,Mohammed K. Ali,Kmv Narayan,Viswanathan Mohan +7 more
TL;DR: In this article, the authors compared the clinical profile and complications between younger and older onset type 2 diabetes (T2DM) patients at a tertiary care diabetes center in south India, and examined odds of having each complication, after adjusting for clinical differences between younger- and older-onset T2DM patients.
Journal ArticleDOI
Type 2 diabetes in a 5-year-old and single center experience of type 2 diabetes in youth under 10
TL;DR: The case of a 5‐year‐old Hispanic male diagnosed with T2DM after referral by his pediatrician for abnormal weight gain, acanthosis nigricans and an elevated HbgA1c is presented and an IRB approved retrospective review of the characteristics of the 20 T1DM patients <10 years of age identified to date is presented.
Journal ArticleDOI
Association of Prenatal and Perinatal Exposures to Particulate Matter With Changes in Hemoglobin A1c Levels in Children Aged 4 to 6 Years.
Emily C. Moody,Alejandra Cantoral,Marcela Tamayo-Ortiz,Ma. Luisa Pizano-Zárate,Lourdes Schnaas,Itai Kloog,Itai Kloog,Emily Oken,Brent A. Coull,Andrea A. Baccarelli,Martha María Téllez-Rojo,Robert O. Wright,Allan C. Just +12 more
TL;DR: This birth cohort study examines the association between prenatal and perinatal exposures to fine particulate matter (diameter <2.5 μm) and changes in hemoglobin A1c levels in children aged 4 to 6 years.
Journal ArticleDOI
Prevention of Type 2 Diabetes among Youth: A Systematic Review, Implications for the School Nurse.
TL;DR: Few school-based studies included high school students; therefore, further research is needed among older adolescents on the efficacy of nonpharmacological interventions in the high school.
References
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TL;DR: In obese individuals, adipose tissue releases increased amounts of non-esterified fatty acids, glycerol, hormones, pro-inflammatory cytokines and other factors that are involved in the development of insulin resistance.
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From the Triumvirate to the Ominous Octet: A New Paradigm for the Treatment of Type 2 Diabetes Mellitus
TL;DR: Eight players comprise the ominous octet and dictate that treatment should be based upon reversal of known pathogenic abnormalities and not simply on reducing the A1C, and therapy must be started early to prevent/slow the progressive β-cell failure that already is well established in IGT subjects.
Journal ArticleDOI
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TL;DR: Insulin resistance was greater in the affected cohort and was the best predictor of impaired glucose tolerance and Overt type 2 diabetes was linked to beta-cell failure.
Journal ArticleDOI
Obesity and Nonalcoholic Fatty Liver Disease: Biochemical, Metabolic and Clinical Implications
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