Pediatric Type 2 Diabetes in Japan: Similarities and Differences from Type 2 Diabetes in Other Pediatric Populations

To review clinical characteristics of pediatric type 2 diabetes in Japan.

It is well recognized that Asian populations, particularly the Japanese, have a higher incidence of childhood type 2 diabetes. Of note, most Asian populations show a higher incidence of pediatric type 2 diabetes than that of type 1 diabetes. However, a current report in the USA demonstrated a dramatic increase in the incidence of young people with type 2 diabetes in recent years. The USA could have a much higher incidence of type 2 diabetes than Japan, possibly due to environmental and behavioral factors. The clinical features of Japanese young people with type 2 diabetes might have some differences from type 2 diabetes in other pediatric populations. Japanese children with type 2 diabetes are likely to be thinner than Caucasian children. Approximately 10-15% Japanese patients with type 2 diabetes exhibit normal weight with milder insulin resistance and substantial insulin secretion failure. Autoimmunity is not associated with the etiology of type 2 diabetes. Some genetic background and environmental factors, different from those in Caucasians, could play a role in the development of type 2 diabetes in Japanese children. Considering these characteristics, we must consider adequate therapy and management for young people with type 2 diabetes.