Treatment of Youth-Onset Type 2 Diabetes: Focus on SGLT-2 Inhibitor Use

The upward trajectory of childhood and adolescent type 2 diabetes (T2D; youth-onset T2D) is a global health issue, disproportionately affecting non-white, ethnically diverse, and socioeconomically disadvantaged subgroups. Youth-onset T2D displays a more aggressive phenotype, with faster disease progression and earlier onset of severe complications when compared to adult-onset T2D. Despite this, the therapeutic options for the management of youth-onset T2D have historically been limited. Over the last few years, multiple new therapies across a range of drug classes, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, have been approved for use in youth-onset T2D. Despite this, patient recruitment to pediatric and adolescent trials remains a major challenge in youth-onset T2D, and there is currently a lack of large-scale, long-term clinical evidence for new treatment classes in this patient population. In this review, we provide an overview of the current treatment landscape in youth-onset T2D and summarize the available clinical data for SGLT-2 inhibitors in patients with youth-onset T2D, based on a targeted literature search.