Description
Type 2 Diabetes in adolescents is emerging as a significant public health concern, driven largely by rising obesity rates and sedentary lifestyles. Unlike type 1 diabetes, it is increasingly diagnosed in younger populations due to poor dietary habits and reduced physical activity. Early onset poses long-term complications, including cardiovascular disease, kidney issues, and nerve damage. Timely intervention through lifestyle modification, early diagnosis, and medical management is crucial to mitigate risks. Raising awareness among families, schools, and healthcare providers is essential to curb this growing epidemic.
Summary Listen
- Type 2 diabetes incidence is projected to increase significantly worldwide by 2050, particularly in Africa and the Middle East, accompanied by substantial financial investment and increased mortality/morbidity. This rise is linked to the growing prevalence of childhood obesity, necessitating early recognition and intervention. Early-onset type 2 diabetes is clinically aggressive, leading to rapid beta cell decline and increased treatment failure rates, highlighting the need to differentiate it from slowly evolving type 1 diabetes.
- Diagnosis relies on criteria such as hyperglycemia symptoms with elevated HbA1c, fasting plasma glucose, or 2-hour plasma glucose levels. Screening is recommended for at-risk youth exhibiting signs of puberty onset after age 10, elevated BMI, family history, insulin resistance indicators (acanthosis, fatty liver, PCOS), or certain ethnicities. Intrauterine hyperglycemia, epigenetic mechanisms, and genetic factors also play significant roles in the etiopathogenesis of type 2 diabetes.
- Management includes diabetes self-management education, normalization of glycemia while minimizing hypoglycemia, weight loss strategies, and addressing comorbidities. Initial treatment typically involves metformin, with considerations for adding GLP-1 agonists or SGLT2 inhibitors in cases of inadequate glycemic control. GLP-1 receptor agonists have shown promise in reducing HbA1c levels and improving cardiovascular risk factors, potentially becoming preferred choices after metformin failure.
- Bariatric surgery may be considered for patients with a BMI exceeding 35 kg/m², although long-term data on outcomes and complications are limited. Regular screening for complications such as nephropathy, retinopathy, fatty liver, and mental health issues is crucial to mitigate long-term morbidity. Novel pharmaceutical interventions, specifically GLP-1 analogs, offer new hope in preventing long-term complications in adolescents with type 2 diabetes.
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