Young-onset type 2 diabetes-Epidemiology, pathophysiology, and management

Area of Science:

• Endocrinology
• Public Health
• Genetics

Background:

• Young-onset type 2 diabetes (Y-T2D) prevalence is increasing globally, particularly in low- and middle-income countries.
• This demographic predominantly affects non-White ethnic and racial populations, presenting unique pathophysiological and management challenges.
• Young individuals are underrepresented in clinical trials, leading to an insufficient evidence base for effective interventions.

Purpose of the Study:

• To review recent epidemiological studies on Y-T2D and its complications.
• To discuss genetic and environmental risk factors contributing to Y-T2D.
• To propose strategies for prevention and management, addressing medical and psychosocial needs of young patients.

Main Methods:

• Literature review summarizing recent epidemiological data and risk factor analyses for Y-T2D.
• Discussion of current challenges in glycemic management and care delivery for young individuals.
• Introduction of the Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes Randomized Controlled Trial (PRISM-RCT) as a novel approach.

Main Results:

• Y-T2D exhibits heterogeneity in genetic and environmental contributions, complicating glycemic control.
• Disabling complications arise at a young age, impacting productivity and quality of life.
• The PRISM-RCT aims to evaluate a structured, precision-based care model integrating biogenetic markers and technology.

Conclusions:

• Addressing the rising incidence of Y-T2D requires tailored prevention and management strategies.
• Precision medicine approaches, like the PRISM-RCT, hold promise for improving outcomes in young patients.
• Understanding the legacy effect is crucial for long-term health in individuals with Y-T2D.