Development of type 2 diabetes in children and adolescents

Altered glucose metabolism in obese youth is an emerging phenomenon of the last 2 decades, strongly associated with the increase in the prevalence of childhood obesity. Peripheral insulin resistance, tightly coupled with obesity in this age group, seems to be the major driving force of deteriorating glucose metabolism. Patterns of lipid partitioning, mainly an increased deposition of fat in the intramyocellular and visceral compartments are strongly associated with insulin resistance in this population. Impaired glucose tolerance in this age group is characterized by a decline in first phase sensitivity of the beta cell while a combined decline of first and second phase sensitivity is the hallmark of type 2 diabetes. The dynamics of impaired glucose metabolism in childhood seem to be faster than in adults, representing a limited window of opportunity for successful preventive intervention.