Salama Mostafa, Biggs Bridget K, Creo Ana, Prissel Rose, Al Nofal Alaa, Kumar Seema
Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Diabetes Metab Syndr Obes. 2023 Mar 9;16:693-711. doi: 10.2147/DMSO.S365829. eCollection 2023.
The prevalence of type 2 diabetes (T2DM) among children and adolescents has remarkably increased in the last two decades, particularly among ethnic minorities. Management of T2DM is challenging in the adolescent population due to a constellation of factors, including biological, socioeconomic, cultural, and psychological barriers. Weight reduction is an essential component in management of T2DM as weight loss is associated with improvement in insulin sensitivity and glycemic status. A family centered and culturally appropriate approach offered by a multidisciplinary team is crucial to address the biological, psychosocial, cultural, and financial barriers to weight management in youth with T2DM. Lifestyle interventions and pharmacotherapy have shown modest efficacy in achieving weight reduction in adolescents with T2DM. Bariatric surgery is associated with excellent weight reduction and remission of T2DM in youth. Emerging therapies for weight reduction in youth include digital technologies, newer GLP-1 agonists and endoscopic procedures.
在过去二十年中,儿童和青少年2型糖尿病(T2DM)的患病率显著上升,尤其是在少数族裔中。由于一系列因素,包括生物学、社会经济、文化和心理障碍,T2DM在青少年人群中的管理具有挑战性。减轻体重是T2DM管理的重要组成部分,因为体重减轻与胰岛素敏感性和血糖状况的改善相关。多学科团队提供的以家庭为中心且符合文化背景的方法对于解决T2DM青少年体重管理中的生物学、心理社会、文化和经济障碍至关重要。生活方式干预和药物治疗在实现T2DM青少年体重减轻方面显示出适度的疗效。减肥手术与青少年显著的体重减轻和T2DM缓解相关。青少年减肥的新兴疗法包括数字技术、新型GLP-1激动剂和内镜手术。