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Rapid progression of type 2 diabetes and related complications in children and young people-A literature review.

Published on Jan 10, 2020in Pediatric Diabetes3.347
· DOI :10.1111/PEDI.12953
Timothy Barrett54
Estimated H-index: 54
,
Muhammad Yazid Jalaludin (Peninsular Malaysia)+ 2 AuthorsNaim Shehadeh22
Estimated H-index: 22
Abstract
Type 2 diabetes (T2D) is suggested to progress faster in children and young people vs type 1 diabetes (T1D) in the same age group and T2D in adults. We reviewed the evidence base for this. A literature search was performed of PubMed-indexed publications between 2000 and 2018, for the terms "pediatric" and "T2D." Results were combined and filtered for those relating to "progression." Searches of abstract books from Latin American and Asian congresses were performed to include these populations. Pediatric populations were defined as <25 completed years of age. Of the articles and congress abstracts found, 30 were deemed relevant. Dividing the studies into categories based on how T2D progresses, we found the following: (a) yearly beta-cell function deterioration was shown to be 20% to 35% in children with T2D compared with 7% to 11% in adults with T2D, despite similar disease durations; (b) retinopathy progression was likely dependent on diabetes duration rather than diabetes type; however, nephropathy, neuropathy and probably hypertension progressed faster in youth-onset T2D vs T1D. Nephropathy progression was similar to adults with T2D, allowing for disease duration. Youth with T2D had a worse cardiovascular (CV) risk profile than youth with T1D, and a faster progression to CV death. (c) Progression to treatment failure was faster in youth-onset T2D vs adult-onset T2D. Substantial evidence exists for faster progression of T2D in pediatric patients vs T1D or adult-onset T2D. New treatments targeting the pathology are needed urgently to address this issue.
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References39
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#2Andrea MariH-Index: 56
Last. Steven E. KahnH-Index: 98
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Results from hyperglycemic clamps in the Restoring Insulin Secretion (RISE) Study found that youth (10-19 y) with impaired glucose tolerance (IGT) or early type 2 diabetes (T2D) are more insulin resistant and secrete more insulin than adults (20-65 y), despite similar BMI. Here we use Mari modeling of RISE 3-h OGTT data to explore differences in β-cell function between youth and adults. The Mari model describes the relationship between insulin secretion rate (ISR) and glucose concentration. The ...
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#1P. Zeitler (University of Colorado Denver)H-Index: 5
#2Silva A. Arslanian (University of Pittsburgh)H-Index: 64
Last. David Maahs (Lucile Packard Children's Hospital)H-Index: 49
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8 CitationsSource
#1Fida BachaH-Index: 31
#2Peiyao ChengH-Index: 15
Last. Roy W. BeckH-Index: 83
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Background/Aims: Many adolescents with type 2 diabetes (T2D) have rapid deterioration of glycemic control on metformin monotherapy within 2 years of diagnosis. &l
6 CitationsSource
#1Deborah A. Elder (Cincinnati Children's Hospital Medical Center)H-Index: 10
#2Lindsey Hornung (Cincinnati Children's Hospital Medical Center)H-Index: 8
Last. David A. D'Alessio (University of Cincinnati Academic Health Center)H-Index: 71
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Abstract Purpose The progression of β-cell function in newly diagnosed adolescents with type 2 diabetes mellitus (T2DM) is not well documented. We hypothesized that at the time of diagnosis with T2DM, adolescents would have impaired β-cell function as demonstrated by the disposition index (calculated as: insulin secretion adjusted for insulin sensitivity), and this would be followed by a rapid decline of function despite standard medical management. Methods Thirty-nine adolescents with recently ...
1 CitationsSource
#1NambamBimota (UF: University of Florida)H-Index: 4
#2Janet H. Silverstein (UF: University of Florida)H-Index: 48
Last. William V. Tamborlane (Yale University)H-Index: 86
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Objective To describe the clinical characteristics, treatment approaches, clinical outcomes, and co-morbidities of youth with type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium (PDC) T2D Registry. Methods PDC enrolled 598 youth <21 yr of age with T2D from February 2012 to July 2015 at eight centers. Data were collected from medical records and interviews with participants and/or parents and included glycated hemoglobin (HbA1c), diabetes treatments, prevalence of diabetes comorbi...
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#1Dana Dabelea (Colorado School of Public Health)H-Index: 67
#2Jeanette M. Stafford (Wake Forest University)H-Index: 18
Last. Catherine Pihoker (UW: University of Washington)H-Index: 39
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Importance The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown. Objective To determine the prevalence of and risk factors for complications related to type 1 diabetes vs type 2 diabetes among teenagers and young adults who had been diagnosed with diabetes during childhood and adolescence. Design, Setting, and Participants Observational study from 2002 to 2015 in 5 US locations, including 2018 participants with type 1 and type 2 diabetes...
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#1Kristen J. Nadeau (University of Colorado Denver)H-Index: 30
#2Barbara J. Anderson (BCM: Baylor College of Medicine)H-Index: 25
Last. Philip Zeitler (University of Colorado Denver)H-Index: 30
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Type 2 diabetes is a significant and increasing burden in adolescents and young adults. Clear strategies for research, prevention, and treatment of the disease in these vulnerable patients are needed. Evidence suggests that type 2 diabetes in children is different not only from type 1 but also from type 2 diabetes in adults. Understanding the unique pathophysiology of type 2 diabetes in youth, as well as the risk of complications and the psychosocial impact, will enable industry, academia, fundi...
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#1William V. Tamborlane (Yale University)H-Index: 86
#2Morey W. Haymond (BCM: Baylor College of Medicine)H-Index: 67
Last. George P. Giacoia (NIH: National Institutes of Health)H-Index: 21
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The Best Pharmaceuticals for Children Act of 2002 mandated that the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) carries out critical reviews of the gaps in knowledge and unmet needs regarding safe and effective pharmacologic treatment of infants, children, and adolescents in a broad range of disease areas. In 2012, NICHD selected diabetes mellitus as one of the pediatric disorders for review. Dr. William V. Tamborlane was named chair, and Dr. Linda DiM...
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#1Tamara S. Hannon (IU: Indiana University)H-Index: 15
#2Silva A. Arslanian (University of Pittsburgh)H-Index: 64
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-r...
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#1Jeanie B. Tryggestad (University of Oklahoma Health Sciences Center)H-Index: 10
#2Steven M. Willi (UPenn: University of Pennsylvania)H-Index: 27
Abstract With the rise in childhood obesity, type 2 diabetes mellitus (T2DM) has been recognized to occur in adolescents with increasing frequency. Although much is known about T2DM in adults, few studies have examined the treatment and complications of T2DM in youth. The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study was designed to evaluate the efficacy of various treatments and provided a unique opportunity to study the disease progression and appearance of compl...
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