Mouraux T, Dorchy H
Clinique de diabétologie, hôpital universitaire des enfants Reine Fabiola, avenue J.-J. Crocq 15, 1020 Bruxelles, Belgique.
Arch Pediatr. 2005 Dec;12(12):1779-84. doi: 10.1016/j.arcped.2005.03.041. Epub 2005 Nov 11.
There has been wide recognition in the past decade of the increasing frequency of type 2 diabetes in youth, largely but not exclusively in North America. In some American locations and populations, incidence and prevalence of type 2 diabetes are much higher than those of type 1 diabetes, because of increased calorie and fat intake, and decreased exercise. The increasing prevalence of type 2 diabetes in the United States has closely paralleled the increase in childhood obesity noted there, but now across the Western world. Besides obesity, the other youth risk factors for type 2 diabetes are: ethnicity, puberty, family history, metabolic syndrome, polycystic ovary syndrome, acanthosis nigricans. Any feature or condition associated with insulin resistance/hyperinsulinemia should alert to screen youth at increased risk for (pre)type 2 diabetes. Treatment goals are to decrease weight and increase exercise, to normalize insulinemia, glycemia and HbA1c, to control hypertension and hyperlipidemia. The aim of the pharmacological therapy is to decrease insulin resistance, namely by metformin. Sometimes, insulin therapy is necessary.
在过去十年中，青少年2型糖尿病发病率不断上升已得到广泛认可，这种情况在很大程度上（但不仅限于）出现在北美。在美国的一些地区和人群中，由于热量和脂肪摄入增加以及运动量减少，2型糖尿病的发病率和患病率远高于1型糖尿病。美国2型糖尿病患病率的上升与儿童肥胖率的增加密切相关，而现在这种现象在整个西方世界都存在。除肥胖外，青少年2型糖尿病的其他风险因素包括：种族、青春期、家族病史、代谢综合征、多囊卵巢综合征、黑棘皮病。任何与胰岛素抵抗/高胰岛素血症相关的特征或状况都应提醒对2型糖尿病（前期）风险增加的青少年进行筛查。治疗目标是减轻体重、增加运动量，使胰岛素血症、血糖和糖化血红蛋白正常化，控制高血压和高脂血症。药物治疗的目的是降低胰岛素抵抗，即使用二甲双胍。有时，胰岛素治疗是必要的。
