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Approach to the Patient: Youth-Onset Type 2 Diabetes
Talia A Hitt1, Tamara S Hannon2, Sheela N Magge1
1Division of Endocrinology and Diabetes, Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Room 3114, Baltimore, MD 21287, USA.
The Journal of Clinical Endocrinology and Metabolism
|August 16, 2023
Summary
Youth-onset type 2 diabetes is a growing global epidemic, particularly affecting minority youth. This condition progresses faster, leading to earlier complications than in adults.
Area of Science:
- Endocrinology
- Pediatrics
- Public Health
Background:
- Youth-onset type 2 diabetes (T2D) is a rapidly increasing global health issue.
- It exhibits unique characteristics in youth, including greater insulin resistance and faster beta-cell decline compared to adult-onset T2D.
- Minority racial and ethnic groups experience the highest prevalence and incidence of youth-onset T2D in the US.
Purpose of the Study:
- To review the unique aspects of youth-onset T2D, including its pathogenesis, diagnosis, risk factors, and management.
- To highlight the accelerated progression and higher complication rates in youth compared to adults.
- To emphasize the importance of a multidisciplinary approach and intensive health behavior therapy.
Main Methods:
- Literature review and synthesis of current research on youth-onset T2D.
- Analysis of epidemiological data on prevalence and incidence.
- Examination of risk factors, diagnostic criteria, and treatment modalities.
Main Results:
- Youth-onset T2D demonstrates more aggressive progression and earlier onset of complications.
- Obesity, family history, certain medications, socioeconomic factors, and birth history are key risk factors.
- Treatment requires a multidisciplinary model, intensive health behavior therapy, and close monitoring for comorbidities.
Conclusions:
- Youth-onset T2D is a distinct and aggressive form of diabetes requiring specialized management.
- Early intervention with lifestyle changes and pharmacotherapy is crucial.
- Metabolic/bariatric surgery shows promise for improving cardiometabolic outcomes in affected youth.
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