Serbis Anastasios, Giapros Vasileios, Kotanidou Eleni P, Galli-Tsinopoulou Assimina, Siomou Ekaterini
Department of Pediatrics, University Hospital of Ioannina, Ioannina 45500, Greece.
Department of Child Health, University of Ioannina, Ioannina 45500, Greece.
World J Diabetes. 2021 Apr 15;12(4):344-365. doi: 10.4239/wjd.v12.i4.344.
During the last two decades, there have been several reports of an increasing incidence of type 2 diabetes mellitus (T2DM) in children and adolescents, especially among those belonging to minority ethnic groups. This trend, which parallels the increases in prevalence and degree of pediatric obesity, has caused great concern, even though T2DM remains a relatively rare disease in children. Youth T2DM differs not only from type 1 diabetes in children, from which it is sometimes difficult to differentiate, but also from T2DM in adults, since it appears to be an aggressive disease with rapidly progressive β-cell decline, high treatment failure rate, and accelerated development of complications. Despite the recent research, many aspects of youth T2DM still remain unknown, regarding both its pathophysiology and risk factor contribution, and its optimal management and prevention. Current management approaches include lifestyle changes, such as improved diet and increased physical activity, together with pharmacological interventions, including metformin, insulin, and the recently approved glucagon-like peptide-1 analog liraglutide. What is more important for everyone to realize though, from patients, families and physicians to schools, health services and policy-makers alike, is that T2DM is a largely preventable disease that will be addressed effectively only if its major contributor (, pediatric obesity) is confronted and prevented at every possible stage of life, from conception until adulthood. Therefore, relevant comprehensive, coordinated, and innovative strategies are urgently needed.
在过去二十年中，有几份报告指出儿童和青少年2型糖尿病（T2DM）的发病率不断上升，尤其是在少数族裔群体中。这一趋势与儿童肥胖症患病率和程度的增加同步，引起了极大关注，尽管T2DM在儿童中仍然是一种相对罕见的疾病。青少年T2DM不仅与儿童1型糖尿病不同，有时难以区分，而且与成人T2DM也不同，因为它似乎是一种侵袭性疾病，β细胞迅速衰退，治疗失败率高，并发症发展加速。尽管最近有相关研究，但青少年T2DM的许多方面，无论是其病理生理学和危险因素的作用，还是其最佳管理和预防，仍然未知。目前的管理方法包括生活方式的改变，如改善饮食和增加体育活动，以及药物干预，包括二甲双胍、胰岛素和最近批准的胰高血糖素样肽-1类似物利拉鲁肽。然而，对每个人来说，从患者、家庭和医生到学校、卫生服务机构和政策制定者，更重要的是要认识到T2DM在很大程度上是一种可预防的疾病，只有在其主要促成因素（即儿童肥胖症）在从受孕到成年的生命各个阶段都得到应对和预防时，才能得到有效解决。因此，迫切需要相关的全面、协调和创新战略。
