La Grasta Sabolic Lavinia, Marusic Sanda, Cigrovski Berkovic Maja
Department of Pediatric Endocrinology and Diabetology, University Hospital Centre Sestre Milosrdnice, Zagreb 10000, Croatia.
School of Medicine, Catholic University of Croatia, Zagreb 10000, Croatia.
World J Diabetes. 2024 May 15;15(5):876-885. doi: 10.4239/wjd.v15.i5.876.
The incidence and prevalence of youth-onset type 2 diabetes mellitus (T2DM) are increasing. The rise in frequency and severity of childhood obesity, inclination to sedentary lifestyle, and epigenetic risks related to prenatal hyperglycemia exposure are important drivers of the youth-onset T2DM epidemic and might as well be responsible for the early onset of diabetes complications. Indeed, youth-onset T2DM has a more extreme metabolic phenotype than adult-onset T2DM, with greater insulin resistance and more rapid deterioration of beta cell function. Therefore, intermediate complications such as microalbuminuria develop in late childhood or early adulthood, while end-stage complications develop in mid-life. Due to the lack of efficacy and safety data, several drugs available for the treatment of adults with T2DM have not been approved in youth, reducing the pharmacological treatment options. In this mini review, we will try to address the present challenges and pitfalls related to youth-onset T2DM and summarize the available interventions to mitigate the risk of microvascular and macrovascular complications.
青年起病的2型糖尿病（T2DM）的发病率和患病率正在上升。儿童肥胖的频率和严重程度增加、久坐不动的生活方式倾向以及与产前高血糖暴露相关的表观遗传风险是青年起病T2DM流行的重要驱动因素，也可能是糖尿病并发症早发的原因。事实上，青年起病的T2DM比成人起病的T2DM具有更极端的代谢表型，胰岛素抵抗更强，β细胞功能恶化更快。因此，微量白蛋白尿等中期并发症在儿童晚期或成年早期出现，而终末期并发症在中年出现。由于缺乏疗效和安全性数据，几种可用于治疗成人T2DM的药物尚未在青年中获得批准，减少了药物治疗选择。在本综述中，我们将试图解决与青年起病T2DM相关的当前挑战和陷阱，并总结现有的干预措施以降低微血管和大血管并发症的风险。
