Unnikrishnan Ranjit, Shah Viral N, Mohan Viswanathan
Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialties Centre, Who Collaborating Centre for Non-Communicable Diseases Prevention and Control, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086 India.
Barbara Davis Center for Diabetes, University of Colorado Anschutz Campus, Aurora, CO USA.
Clin Diabetes Endocrinol. 2016 Nov 10;2:18. doi: 10.1186/s40842-016-0036-6. eCollection 2016.
The prevalence of diabetes in children and adolescents is increasing worldwide, with profound implications on the long-term health of individuals, societies, and nations. The diagnosis and management of diabetes in youth presents several unique challenges. Although type 1 diabetes is more common among children and adolescents, the incidence of type 2 diabetes in youth is also on the rise, particularly among certain ethnic groups. In addition, less common types of diabetes such as monogenic diabetes syndromes and diabetes secondary to pancreatopathy (in some parts of the world) need to be accurately identified to initiate the most appropriate treatment. A detailed patient history and physical examination usually provides clues to the diagnosis. However, specific laboratory and imaging tests are needed to confirm the diagnosis. The management of diabetes in children and adolescents is challenging in some cases due to age-specific issues and the more aggressive nature of the disease. Nonetheless, a patient-centered approach focusing on comprehensive risk factor reduction with the involvement of all concerned stakeholders (the patient, parents, peers and teachers) could help in ensuring the best possible level of diabetes control and prevention or delay of long-term complications.
全球范围内，儿童和青少年糖尿病的患病率正在上升，这对个人、社会和国家的长期健康有着深远影响。青少年糖尿病的诊断和管理面临一些独特挑战。虽然1型糖尿病在儿童和青少年中更为常见，但青少年2型糖尿病的发病率也在上升，尤其是在某些种族群体中。此外，还需要准确识别不太常见的糖尿病类型，如单基因糖尿病综合征和继发于胰腺疾病的糖尿病（在世界某些地区），以便开始最恰当的治疗。详细的患者病史和体格检查通常能为诊断提供线索。然而，需要特定的实验室和影像学检查来确诊。由于特定年龄问题以及该疾病更具侵袭性的特点，儿童和青少年糖尿病的管理在某些情况下具有挑战性。尽管如此，以患者为中心的方法，注重在所有相关利益攸关方（患者、父母、同龄人及教师）的参与下全面降低危险因素，有助于确保实现尽可能最佳的糖尿病控制水平，并预防或延缓长期并发症。
