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Early microvascular complications in type 1 and type 2 diabetes: recent developments and updates
Kalie L Tommerdahl1,2,3,4, Allison L B Shapiro1,5, Edward J Nehus6
1Department of Pediatrics, Section of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 E. 16th Avenue, Box B265, Aurora, CO, 80045, USA.
Pediatric Nephrology (Berlin, Germany)
|April 14, 2021
Summary
Youth-onset diabetes is rising globally. Early detection and management of microvascular complications in type 1 (T1D) and type 2 (T2D) diabetes are crucial to prevent long-term health issues.
Area of Science:
- Pediatric Endocrinology
- Diabetology
- Nephrology
Background:
- Youth-onset diabetes (type 1 and type 2) is increasing worldwide.
- Poor glycemic control, diabetes duration, and comorbidities accelerate microvascular complications in youth.
- Microvascular complications are often underdiagnosed in pediatric diabetes populations, leading to undertreatment.
Purpose of the Study:
- To provide a comprehensive review of microvascular complications in youth with T1D and T2D.
- To highlight challenges in managing pediatric diabetes and identify risk factors.
- To emphasize early identification and discuss current/future treatment strategies.
Main Methods:
- Narrative review of epidemiology, risk factors, symptoms, screening, and treatment.
- Focus on pediatric populations with type 1 and type 2 diabetes.
- Comparison of microvascular complications in T1D versus T2D.
Main Results:
- Microvascular complications (kidney disease, retinopathy, neuropathy) develop early in youth with diabetes.
- Underdiagnosis leads to delayed intervention and increased morbidity/mortality risk.
- Early pathological vascular changes in youth present a critical window for intervention.
Conclusions:
- Early identification of at-risk youth is paramount for mitigating microvascular complications.
- Dedicated pediatric outcome trials are needed to investigate novel treatment mechanisms.
- Targeting early vascular changes can significantly reduce long-term complications in pediatric diabetes.
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