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Type 2 Diabetes in Latino Youth: A Clinical Update and Current Challenges

Published on Jan 1, 2019in Current Problems in Pediatric and Adolescent Health Care 2.33
· DOI :10.1016/j.cppeds.2018.11.008
Paulina Cruz1
Estimated H-index: 1
(WashU: Washington University in St. Louis),
Andrea Granados2
Estimated H-index: 2
(WashU: Washington University in St. Louis)
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Abstract
Latino youth have the highest prevalence of overweight and obesity among all ethnic groups and are disproportionally affected by pre diabetes and type 2 diabetes (T2DM). Interventions that effectively reduce the risk of pre diabetes and T2DM in this population are urgently needed. Studies have shown that without any change, 50% of Latino children and adolescents will develop T2DM. This has important public health implications. Few pharmacologic options are approved for use in the pediatric population. The largest clinical trial to date did include a significant sample of Latinos, however the intervention used metformin or rosiglitazone in addition to lifestyle management and did not show meaningful weight loss, with around half of the participants meeting criteria for treatment failure. On the other hand, a smaller trial on surgical treatment of adolescents with severe obesity and T2DM resulted in superior glycemic control, reduced weight, and improvement of other co-morbidities of T2DM in youth. Lastly, culturally tailored programs that focus on building healthy communities appear to be a promising intervention to reduce diabetes risk in Latino youth. This review provides an update on the clinical aspects of T2DM in Latino youth and focuses on management and prevention strategies.
  • References (35)
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References35
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Published on Jul 1, 2018in Obesity Surgery 3.60
Nesreen Khidir3
Estimated H-index: 3
(Hamad Medical Corporation),
Moamena Ahmed El-Matbouly3
Estimated H-index: 3
(Hamad Medical Corporation)
+ 3 AuthorsMichel Gagner54
Estimated H-index: 54
Background Bariatric surgery in adolescents is still under debate. Literature about the long-term impact of laparoscopic sleeve gastrectomy (LSG) on adolescents’ obesity and associated morbidities is scarce. It is unknown if LSG shows better long-term results in the adolescent or adult group.
Published on May 1, 2018in JAMA Pediatrics 12.00
Thomas H. Inge41
Estimated H-index: 41
(University of Colorado Denver),
Lori Laffel60
Estimated H-index: 60
(Joslin Diabetes Center)
+ 7 AuthorsPhilip Zeitler25
Estimated H-index: 25
(University of Colorado Denver)
Importance Because of the substantial increase in the occurrence of type 2 diabetes in the pediatric population and the medical complications of this condition, therapies are urgently needed that will achieve better glycemic control than standard medical management. Objective To compare glycemic control in cohorts of severely obese adolescents with type 2 diabetes undergoing medical and surgical interventions. Design, Setting, and Participants A secondary analysis of data collected by the Teen–L...
Published on Dec 1, 2017in BMC Public Health 2.57
Erica G. Soltero4
Estimated H-index: 4
(ASU: Arizona State University),
Yolanda P. Konopken5
Estimated H-index: 5
+ 11 AuthorsMatthew Sandoval1
Estimated H-index: 1
Abstract Background Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-te...
Published on Nov 1, 2017in The Lancet Child & Adolescent Health
Ram Weiss33
Estimated H-index: 33
(Boston Children's Hospital),
Nicola Santoro27
Estimated H-index: 27
(Yale University)
+ 3 AuthorsSonia Caprio65
Estimated H-index: 65
(Yale University)
Summary Obesity has been estimated to decrease life expectancy by as little as 0·8 years to as much as 7 years, and is the second leading cause of preventable death—after smoking—in the USA. Alongside the increase in the prevalence of obesity, prediabetes and type 2 diabetes have become more common in adolescents. Yet, little is known about the pathogenesis of these conditions in the paediatric population and how prediabetes could be detected at an early stage to prevent progression towards over...
Published on Oct 1, 2017in American Journal of Preventive Medicine 4.43
Jessica L. McCurley5
Estimated H-index: 5
(UCSD: University of California, San Diego),
Margaret A Crawford1
Estimated H-index: 1
(UCSD: University of California, San Diego),
Linda C. Gallo34
Estimated H-index: 34
(SDSU: San Diego State University)
Context Prevalence of type 2 diabetes mellitus (T2DM) in youth has increased rapidly in recent decades along with rises in childhood obesity. Disparities in risk and prevalence of T2DM are evident in Hispanic youth when compared with non-Hispanic whites. Targeted diabetes prevention programs have been recommended to reduce risk prior to adulthood in this population. This systematic review explores the effectiveness of lifestyle-based diabetes prevention interventions for Hispanic youth. Evidence...
Published on Apr 13, 2017in The New England Journal of Medicine 70.67
Elizabeth J. Mayer-Davis9
Estimated H-index: 9
,
Jean M. Lawrence52
Estimated H-index: 52
(KP: Kaiser Permanente)
+ 10 AuthorsDavid J. Pettitt78
Estimated H-index: 78
BackgroundDiagnoses of type 1 and type 2 diabetes in youths present a substantial clinical and public health burden. The prevalence of these diseases increased in the 2001–2009 period, but data on recent incidence trends are lacking. MethodsWe ascertained cases of type 1 and type 2 diabetes mellitus at five study centers in the United States. Denominators (4.9 million youths annually) were obtained from the U.S. Census or health-plan member counts. After the calculation of annual incidence rates...
Published on Jan 14, 2016in The New England Journal of Medicine 70.67
Thomas H. Inge41
Estimated H-index: 41
,
Anita P. Courcoulas43
Estimated H-index: 43
+ 9 AuthorsStavra A. Xanthakos28
Estimated H-index: 28
BackgroundBariatric surgery is increasingly considered for the treatment of adolescents with severe obesity, but few prospective adolescent-specific studies examining the efficacy and safety of weight-loss surgery are available to support clinical decision making. MethodsWe prospectively enrolled 242 adolescents undergoing weight-loss surgery at five U.S. centers. Patients undergoing Roux-en-Y gastric bypass (161 participants) or sleeve gastrectomy (67) were included in the analysis. Changes in ...
Published on Oct 1, 2015in Journal of Immigrant and Minority Health 1.58
Ming Wen34
Estimated H-index: 34
(UofU: University of Utah),
Dejun Su13
Estimated H-index: 13
(UNMC: University of Nebraska Medical Center)
Little is known about leisure-time physical activity (LTPA) correlates in high-risk youth prone to obesity, insulin resistance, and associated morbidities. This study examined LTPA correlates among Latino youth identified with acanthosis nigricans (AN), a skin condition typically caused by metabolic impairment. Data were collected on 305 AN-positive Latino youth of ages 5–15 and one of their biological parents in 2012 from Texas. Ordinal logit regression was performed to analyze the data. Five h...
Published on Aug 1, 2015in Childhood obesity 2.43
Noereem Mena4
Estimated H-index: 4
,
Kathleen S. Gorman11
Estimated H-index: 11
(URI: University of Rhode Island)
+ 2 AuthorsAlison Tovar17
Estimated H-index: 17
(URI: University of Rhode Island)
Abstract Background: Parental feeding practices shape children's dietary preferences and behaviors, which can influence a child's weight status. Limited research exists on the precursors and contextual influences of feeding, particularly among Hispanic parents. Therefore, this study explored two areas potentially important for obesity prevention in young children: (1) precursors and contextual influences on parental feeding and (2) parental perceptions and knowledge of the child care food enviro...
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