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儿童和青少年 2 型糖尿病:独特特征和循证管理。

Type 2 diabetes in children and adolescents: distinct characteristics and evidence-based management.

机构信息

Diabetes and Obesity Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece.

Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Endocrine. 2022 Nov;78(2):280-295. doi: 10.1007/s12020-022-03172-y. Epub 2022 Aug 27.

Abstract

PURPOSE

Since the dramatic rise of obesity prevalence in childhood and adolescence has contributed to increased rates of type 2 diabetes (T2D) in youth, we sought to explore current evidence-based management options for pediatric T2D patients.

METHODS

A comprehensive literature search was performed for studies of T2D in childhood and adolescence until September 2021.

RESULTS

Special pathophysiological and diagnostic characteristics of T2D in this age are presented, while the main focus of the article is on management. Lifestyle interventions with healthy diet and exercise are of great importance for the treatment of T2D in children and adolescents. Metformin and insulin remain the traditional therapeutical means, while liraglutide recently gained indication for children older than 10 years both in USA and Europe. Data on the use, efficacy, safety and therapeutic considerations of other pharmacological treatments in children and adolescents with T2D are critically discussed.

CONCLUSION

Although many new and promising therapeutic strategies have been introduced during recent years for the management of T2D in adults, available therapeutic options for the management of pediatric T2D remain limited.

摘要

目的

由于儿童和青少年肥胖患病率的急剧上升导致青年 2 型糖尿病 (T2D) 发病率增加,我们试图探讨目前针对儿科 T2D 患者的循证管理选择。

方法

对截至 2021 年 9 月的儿童和青少年 T2D 研究进行了全面的文献检索。

结果

介绍了 T2D 在该年龄段的特殊病理生理学和诊断特征,而本文的主要重点是管理。对于儿童和青少年 T2D 的治疗,健康饮食和运动的生活方式干预非常重要。二甲双胍和胰岛素仍然是传统的治疗手段,而利拉鲁肽最近在美国和欧洲均被批准用于 10 岁以上的儿童。对儿童和青少年 T2D 中其他药物治疗的使用、疗效、安全性和治疗注意事项的数据进行了批判性讨论。

结论

尽管近年来针对成人 T2D 的管理引入了许多新的有前途的治疗策略,但儿科 T2D 的管理选择仍然有限。

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