Type 2 diabetes in children and adolescents

Abstract

Type 2 diabetes mellitus is characterized by hyperglycemia secondary to insulin resistance as well as by impaired insulin secretion. Obesity is a major modifiable risk factor for type 2 diabetes and exacerbates insulin resistance. Given the current obesity epidemic, the incidence of type 2 diabetes is rising rapidly in young people and parallels the increasing frequency of the disease observed in the adult population. Treatment is dependent on mode of presentation, with initiation of insulin for metabolic decompensation. The mainstay of therapy is lifestyle modification focusing on healthy eating and regular physical activity. Implementation of such measures can be extremely challenging and should involve the entire family. Pharmacological agents such as metformin are often necessary for optimal glycemic control. Given that youth with type 2 diabetes have been found to develop earlier and more aggressive microvascular complications, yearly screening for retinopathy and nephropathy should begin at diagnosis.