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The changing face of diabetes in youth: lessons learned from studies of type 2 diabetes
Author(s) -
Han Tamara S.,
Arslanian Silva A.
Publication year - 2015
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.12939
Subject(s) - type 2 diabetes , diabetes mellitus , maladaptation , medicine , insulin resistance , metformin , disease , obesity , epidemiology , intensive care medicine , endocrinology , psychiatry
The incidence of youth type 2 diabetes (T2D), linked with obesity and declining physical activity in high‐risk populations, is increasing. Recent multicenter studies have led to a number of advances in our understanding of the epidemiology, pathophysiology, diagnosis, treatment, and complications of this disease. As in adult T2D, youth T2D is associated with insulin resistance, together with progressive deterioration in β cell function and relative insulin deficiency in the absence of diabetes‐related immune markers. In contrast to adult T2D, the decline in β cell function in youth T2D is three‐ to fourfold faster, and therapeutic failure rates are significantly higher in youth than in adults. Whether the more aggressive nature of youth T2D is driven by genetic heterogeneity or physiology/metabolic maladaptation is yet unknown. Besides metformin, the lack of approved pharmacotherapeutic agents for youth T2D that target the pathophysiological mechanisms is a major barrier to optimal diabetes management. There is a significant need for effective therapeutic options, in addition to increased prevention, to halt the projected fourfold increase in youth T2D by 2050 and the consequences of heightened diabetes‐related morbidity and mortality at younger ages.