O'Connor M Rebecca, Doorenbos Ardith, Voss Joachim
1School of Nursing, Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
Biol Res Nurs. 2014 Apr;16(2):218-27. doi: 10.1177/1099800412473820. Epub 2013 Feb 2.
The purpose of this clinical update is to review the etiology of diabetes types affecting youth under 20 and describe diabetes-related genetic and autoimmune biomarkers based on the most recent literature. This information will support diabetes care providers' efforts to better explain the complex topic to patients and families.
A PubMed search identified 396 reviews published from 2008 to 2011 that included the topics of etiology, epidemiology, genetics/epigenetics, pathogenesis, or immunology related to diabetes in youth. The current clinical update includes 19 of these.
The majority of youth under 20 years with diabetes have Type 1 diabetes. Other forms of the disease affecting this population include Type 2, monogenic, and secondary diabetes. Genetic and autoimmune biomarkers can help determine the risk and diagnosis of both Type 1 and monogenic diabetes. An accurate diagnosis of diabetes type allows for determination of optimal treatment options.
The complexity of determining etiology, risk, diagnosis, and treatment for diabetes in youth is increasing with the rate of related genetic and immunologic advances. Diabetes care providers must be able to explain the complex genetic and autoimmune biomarkers used in determining the risk of diabetes, diagnosis of the disease, and identification of treatment options to patients and families.
本次临床进展回顾旨在探讨20岁以下青少年糖尿病的病因，并依据最新文献描述与糖尿病相关的遗传和自身免疫生物标志物。这些信息将有助于糖尿病护理人员更好地向患者及其家属解释这一复杂话题。
通过PubMed检索，确定了2008年至2011年发表的396篇综述，这些综述涵盖了与青少年糖尿病病因、流行病学、遗传学/表观遗传学、发病机制或免疫学相关的主题。本次临床进展回顾纳入了其中的19篇。
20岁以下患糖尿病的青少年大多为1型糖尿病。影响该人群的其他糖尿病类型包括2型、单基因和继发性糖尿病。遗传和自身免疫生物标志物有助于确定1型糖尿病和单基因糖尿病的风险及诊断。准确诊断糖尿病类型有助于确定最佳治疗方案。
随着相关遗传和免疫学进展的加快，确定青少年糖尿病病因、风险、诊断和治疗的复杂性日益增加。糖尿病护理人员必须能够向患者及其家属解释用于确定糖尿病风险、疾病诊断和治疗方案选择的复杂遗传和自身免疫生物标志物。
