Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics and Gynecology, University Hospital of Verona, Verona, Italy.
Department of Experimental Medicine, Tor Vergata University, Rome, Italy.
Minerva Pediatr (Torino). 2021 Dec;73(6):549-562. doi: 10.23736/S2724-5276.21.06530-7. Epub 2021 Jul 21.
Type 2 diabetes (T2D) in adolescents has become an increasing health concern throughout the world and its prevention and screening should be implemented in pediatric care. As clinical features at presentation, in some cases can be similar to type 1 diabetes and family history can be in favor of a monogenic form of diabetes, it is pivotal for physicians to be aware of youth-onset T2D specificities to ensure an accurate diagnosis.
We conducted the first search in Medline, Embase, Web of Science, using different keywords and their compositions. The keywords used, also called "mesh" (MEdical Subject Headings) on PubMed, are the following: "type 2 diabetes" AND ("child*" OR "pediatr*" OR "adolesce*") AND ("epidem*" OR "diagnos*" OR "treat*" OR "complication" OR "comorbidit*"). International review, systematic reviews and meta-analyses, randomized control trials and case reports published between May 2018 and February 2021 were considered, to identify publications that deal with the topic. No restrictions were applied regarding the published paper's language.
The global increase of overweight and obesity can complicate the diagnostic process and makes it essential to apply a systematic approach to each new diagnosis. Microvascular complications may be present at the time of diagnosis and chronic complications are frequent and need to be screened regularly. Regular screening of comorbidities should also be performed. Childhood T2D should be followed up by pediatric diabetes units to avoid diagnostic errors and delay in care.
A multidisciplinary approach, by an experienced team, is pivotal to provide treatment options targeting the unique needs of pediatric patients. Treatment programs must include the whole family and address all the aspects of the care (lifestyle, pharmacological therapy, psychological aspects, complications and comorbidities). An organized process of transition to adult care is essential.
青少年 2 型糖尿病（T2D）已成为全球日益严重的健康问题，应在儿科护理中实施预防和筛查。由于某些情况下表现出的临床特征可能类似于 1 型糖尿病，且家族史可能支持单基因糖尿病形式，因此医生必须意识到青少年起病 T2D 的特殊性，以确保准确诊断。
我们首次在 Medline、Embase、Web of Science 上进行了搜索，使用了不同的关键词及其组合。在 PubMed 上，这些关键词也称为“mesh”（医学主题词），如下所示：“type 2 diabetes” AND（“child*”或“pediatr*”或“adolesce*”）AND（“epidem*”或“diagnos*”或“treat*”或“complication”或“comorbidit*”）。我们考虑了 2018 年 5 月至 2021 年 2 月期间发表的国际评论、系统评价和荟萃分析、随机对照试验和病例报告，以确定涉及该主题的出版物。对于已发表论文的语言，我们没有任何限制。
超重和肥胖的全球增加可能会使诊断过程复杂化，因此必须对每个新诊断采用系统方法。微血管并发症可能在诊断时就已存在，且慢性并发症很常见，需要定期筛查。还应定期筛查合并症。儿科糖尿病单位应跟进儿童 T2D，以避免诊断错误和治疗延误。
由经验丰富的团队进行的多学科方法对于提供针对儿科患者独特需求的治疗方案至关重要。治疗方案必须包括整个家庭，并解决护理的所有方面（生活方式、药物治疗、心理方面、并发症和合并症）。有组织的过渡到成人护理过程是必不可少的。
