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Prevalence Of Type 2 Diabetes In Youth

Type 2 Diabetes In Childhood: Epidemiological And Clinical Aspects

Type 2 Diabetes In Childhood: Epidemiological And Clinical Aspects

Type 2 diabetes in childhood: epidemiological and clinical aspects Warwick Medical School, Clinical Sciences Research Institute University Hospital Coventry and Warwickshire NHS Trust University Hospital Coventry and Warwickshire NHS Trust British Medical Bulletin, Volume 86, Issue 1, 1 June 2008, Pages 5975, K. A. Matyka; Type 2 diabetes in childhood: epidemiological and clinical aspects, British Medical Bulletin, Volume 86, Issue 1, 1 June 2008, Pages 5975, The global obesity epidemic has raised concerns about the risk of a tide of Type 2 diabetes (T2DM) in childhood. This paper aims to review the recent data on the epidemiology of this problem as well as the clinical concerns. A literature search was performed on Medline, and articles about childhood T2DM, in English and published from 2000 to 2008, were reviewed. A review of 16 paediatric studies suggest that although T2DM is now more widely reported in childhood, the numbers are still reasonably small although the data do suggest that ethnicity is an important risk factor. Although there are emerging data on what appears to be a significant risk of both microvascular and macrovascular complications in youth onset T2DM, the most appropriate management remains unclear. Currently, adult guidelines for management of T2DM are being extrapolated to the adolescent population with T2DM. Type 2 diabetes mellitus (T2DM) has long been considered a disease of adult middle age, and patients were often overweight or obese, presented incidentally and had a variety of associated cardiovascular disease (CVD) risk factors. Paediatricians, on the other hand, saw only young, slim children with a rapid onset of osmotic symptoms who needed insulin treatment immediately without which they would become seriously ill. Over the last 20 yea Continue reading >>

Get Unlimited Access On Medscape.

Get Unlimited Access On Medscape.

You’ve become the New York Times and the Wall Street Journal of medicine. A must-read every morning. ” Continue reading >>

Obesity And Type 2 Diabetes In Our Youth: A Recipe For Cardiovascular Disease

Obesity And Type 2 Diabetes In Our Youth: A Recipe For Cardiovascular Disease

Jump to Section Highlights • Cardiovascular disease continues to be the leading cause of death worldwide, contributing to 635,000 deaths in the United States each year. • Reducing the incidence of obesity and type 2 diabetes in children and adolescents may not only prolong life expectancy but also decrease the incidence of cardiovascular disease. • Nurse practitioners are twice as likely to monitor A1C levels, and 37% more likely to meet cholesterol level guideline established according to the consensus statement by the American Heart Association and the American Diabetes Association 2015. • Nurse practitioners are in a unique position to not only provide primary care to children and adolescents but also to develop unique interventions that can improve quality of life. Jump to Section Abstract Cardiovascular disease continues to be the leading cause of death worldwide. According to the American Heart Association, at least 68% of the population with diabetes will die from some form of heart disease. Type 2 diabetes is steadily increasing in children and adolescents, creating a detrimental impact on health. The combination of diabetes and heart disease greatly reduces quality of life and life expectancy. According to current data, nurse practitioners are twice as likely to monitor A1C levels, and 37% more likely to meet cholesterol level guidelines. The nurse practitioner’s role is to provide high-quality care to children and adolescents with type 2 diabetes to improve health and prevent complications. Continue reading >>

Epidemiology, Presentation, And Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents

Epidemiology, Presentation, And Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents

INTRODUCTION Since the early 1990s, the incidence of type 2 diabetes mellitus (T2DM) has increased in children and adolescents and is linked to the rise in childhood obesity. T2DM and its comorbidities are risk factors for vascular disease later in life. As a result, it is imperative for health care providers to identify and treat children and adolescents with this disorder. (See "Definition; epidemiology; and etiology of obesity in children and adolescents".) The epidemiology, presentation, and diagnosis of T2DM in children and adolescents are presented here. Other aspects of T2DM in youth are discussed in separate topic reviews: Continue reading >>

Type 2 Diabetes In Children And Adolescents

Type 2 Diabetes In Children And Adolescents

Regular exercise, a healthy diet, and glycemic control are key to managing this complex metabolic disorder. Type 2 diabetes mellitus is characterized by hyperglycemia secondary to insulin resistance as well as by impaired insulin secretion. Obesity is a major modifiable risk factor for type 2 diabetes and exacerbates insulin resistance. Given the current obesity epidemic, the incidence of type 2 diabetes is rising rapidly in young people and parallels the increasing frequency of the disease observed in the adult population. Treatment is dependent on mode of presentation, with initiation of insulin for metabolic decompensation. The mainstay of therapy is lifestyle modification focusing on healthy eating and regular physical activity. Implementation of such measures can be extremely challenging and should involve the entire family. Pharmacological agents such as metformin are often necessary for optimal glycemic control. Given that youth with type 2 diabetes have been found to develop earlier and more aggressive microvascular complications, yearly screening for retinopathy and nephropathy should begin at diagnosis. Type 2 diabetes mellitus (T2D) in children and adolescents is a growing public health concern and reflects the increasing rates of obesity in our society. Reports from various centres in the United States suggest a tenfold to thirtyfold increase in the number of children with T2D over the past 15 years.[1] These studies focused primarily on children from ethnic groups at high risk for T2D, including children of African, Asian, Hispanic, Pacific Island, and American Indian heritage. However, there are currently no epidemiological data for Canadian children belonging to most of these ethnic groups, with the exception of First Nations children. The prevalence of T Continue reading >>

Prevalence Of Type 1 And Type 2 Diabetes Among Children And Adolescents From 2001 To 2009

Prevalence Of Type 1 And Type 2 Diabetes Among Children And Adolescents From 2001 To 2009

Importance Despite concern about an “epidemic,” there are limited data on trends in prevalence of either type 1 or type 2 diabetes across US race and ethnic groups. Objective To estimate changes in the prevalence of type 1 and type 2 diabetes in US youth, by sex, age, and race/ethnicity between 2001 and 2009. Design, Setting, and Participants Case patients were ascertained in 4 geographic areas and 1 managed health care plan. The study population was determined by the 2001 and 2009 bridged-race intercensal population estimates for geographic sites and membership counts for the health plan. Main Outcomes and Measures Prevalence (per 1000) of physician-diagnosed type 1 diabetes in youth aged 0 through 19 years and type 2 diabetes in youth aged 10 through 19 years. Results In 2001, 4958 of 3.3 million youth were diagnosed with type 1 diabetes for a prevalence of 1.48 per 1000 (95% CI, 1.44-1.52). In 2009, 6666 of 3.4 million youth were diagnosed with type 1 diabetes for a prevalence of 1.93 per 1000 (95% CI, 1.88-1.97). In 2009, the highest prevalence of type 1 diabetes was 2.55 per 1000 among white youth (95% CI, 2.48-2.62) and the lowest was 0.35 per 1000 in American Indian youth (95% CI, 0.26-0.47) and type 1 diabetes increased between 2001 and 2009 in all sex, age, and race/ethnic subgroups except for those with the lowest prevalence (age 0-4 years and American Indians). Adjusted for completeness of ascertainment, there was a 21.1% (95% CI, 15.6%-27.0%) increase in type 1 diabetes over 8 years. In 2001, 588 of 1.7 million youth were diagnosed with type 2 diabetes for a prevalence of 0.34 per 1000 (95% CI, 0.31-0.37). In 2009, 819 of 1.8 million were diagnosed with type 2 diabetes for a prevalence of 0.46 per 1000 (95% CI, 0.43-0.49). In 2009, the prevalence of type Continue reading >>

Type 2 Diabetes Among Youth Doubles Over 5 Years, Troubling For Later Cancer Risk

Type 2 Diabetes Among Youth Doubles Over 5 Years, Troubling For Later Cancer Risk

Among kids, teens and young adults, private insurance claims for type 2 diabetes more than doubled from 2011 to 2015, according to a new paper from an organization that analyzes healthcare costs and insurance. Obesity claims also increased during this same time period. The report from FAIR Health adds to the concerning data on obesity and diabetes among youth. While obesity among children has leveled off in recent years, the increase over the past several decades now means more than one in three children and adolescents are overweight or obese. The findings hold concerning information on cancer risk as these youth may face many decades later. Children and teens who are overweight are more likely to be overweight adults. Among adults, obesity links to increased risk of 11 cancers. And adults diagnosed with type 2 diabetes are at increased risk of developing cancer. Adults with diabetes are approximately twice as likely to develop cancers of the liver, pancreas and endometrium. Risk also increases for cancers of the colon/rectum, breast (post-menopausal) and bladder. For the analysis, FAIR Health analyzed five years of healthcare insurance claims from over 21 billion privately billed healthcare claims. The paper focused on children, teens, and adults ages 22 and younger. Here’s the full white paper by FAIR (pdf), called Obesity and Type 2 Diabetes as Documented in Private Claims Data: Spotlight on This Growing Issue among the Nation’s Youth. Among the paper’s findings, from 2011-2015: – The claim lines with a type 2 diabetes diagnosis more than doubled among newborns to 22 year olds, an increase of 109 percent – The percent of claim lines with an obesity diagnosis increased annually in all age groups, from infants and toddlers to adults – The largest increase Continue reading >>

Rates Of New Diagnosed Cases Of Type 1 And Type 2 Diabetes On The Rise Among Children, Teens

Rates Of New Diagnosed Cases Of Type 1 And Type 2 Diabetes On The Rise Among Children, Teens

Fastest rise seen among racial/ethnic minority groups. Rates of new diagnosed cases of type 1 and type 2 diabetes are increasing among youth in the United States, according to a report, Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012 (link is external), published today in the New England Journal of Medicine. In the United States, 29.1 million people are living with diagnosed or undiagnosed diabetes, and about 208,000 people younger than 20 years are living with diagnosed diabetes. This study is the first ever to estimate trends in new diagnosed cases of type 1 and type 2 diabetes in youth (those under the age of 20), from the five major racial/ethnic groups in the U.S.: non-Hispanic whites, non-Hispanic blacks, Hispanics, Asian Americans/Pacific Islanders, and Native Americans. However, the Native American youth who participated in the SEARCH study are not representative of all Native American youth in the United States. Thus, these rates cannot be generalized to all Native American youth nationwide. The SEARCH for Diabetes in Youth study (link is external), funded by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), found that from 2002 to 2012, incidence, or the rate of new diagnosed cases of type 1 diabetes in youth increased by about 1.8 percent each year. During the same period, the rate of new diagnosed cases of type 2 diabetes increased even more quickly, at 4.8 percent. The study included 11,244 youth ages 0-19 with type 1 diabetes and 2,846 youth ages 10-19 with type 2. “Because of the early age of onset and longer diabetes duration, youth are at risk for developing diabetes related complications at a younger age. This profoundly lessens their quality of life, shortens their life expectanc Continue reading >>

Global Trends In The Incidence And Prevalence Of Type 2 Diabetes In Children And Adolescents: A Systematic Review And Evaluation Of Methodological Approaches

Global Trends In The Incidence And Prevalence Of Type 2 Diabetes In Children And Adolescents: A Systematic Review And Evaluation Of Methodological Approaches

Abstract This study aimed to systematically review what has been reported on the incidence and prevalence of type 2 diabetes in children and adolescents, to scrutinise the methodological issues observed in the included studies and to prepare recommendations for future research and surveillances. Methods PubMed, the Cochrane Database of Systematic Reviews, Scopus, EMBASE and Web of Science were searched from inception to February 2013. Population-based studies on incidence and prevalence of type 2 diabetes in children and adolescents were summarised and methodologically evaluated. Owing to substantial methodological heterogeneity and considerable differences in study populations a quantitative meta-analysis was not performed. Results Among 145 potentially relevant studies, 37 population-based studies met the inclusion criteria. Variations in the incidence and prevalence rates of type 2 diabetes in children and adolescents were mainly related to age of the study population, calendar time, geographical regions and ethnicity, resulting in a range of 0–330 per 100,000 person-years for incidence rates, and 0–5,300 per 100,000 population for prevalence rates. Furthermore, a substantial variation in the methodological characteristics was observed for response rates (60–96%), ascertainment rates (53–99%), diagnostic tests and criteria used to diagnose type 2 diabetes. Worldwide incidence and prevalence of type 2 diabetes in children and adolescents vary substantially among countries, age categories and ethnic groups and this can be explained by variations in population characteristics and methodological dissimilarities between studies. Notes The authors would like to thank N. Zuiverloon (librarian at the library of Utrecht University) for her helpful suggestions for sear Continue reading >>

Diabetes Rates Skyrocket In Kids And Teens

Diabetes Rates Skyrocket In Kids And Teens

The prevalence of diabetes in children shot up dramatically between 2000 and 2009, a new study shows. The amount of type 1 diabetes, an autoimmune disease, climbed 21% from 2000 to 2009, to 1.93 per 1,000 children. The prevalence of type 2 diabetes — which is associated with obesity — jumped more than 30% in the same period, to a rate of 0.46 per 1,000 kids, according to a study presented Saturday at the Pediatric Academic Societies' meeting in Vancouver, Canada. Nationwide, nearly 167,000 children and teens younger than 20 have type 1 diabetes, while more than 20,000 have type 2, says study author Dana Dabelea, of the Colorado School of Public Health in Aurora, Colo. "These increases are serious," Dabelea says. "Every new case means a lifetime burden of difficult and costly treatment and higher risk of early, serious complications." The new study, published in the Journal of the American Medical Association, is the most comprehensive available, said David Ludwig, director of the New Balance Foundation Obesity Prevention Center at Boston Children's Hospital, who was not involved in the study. The research, called the SEARCH for Diabetes in Youth Study, included 3 million children and adolescents in different regions of the USA. Researchers acknowledge that the study doesn't include information from the last five years. "We don't know what happened in the last five years," Ludwig says. "Most likely, things have gotten worse." Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, occurs when the pancreas makes little or no insulin, a hormone that the body needs to let sugar to enter cells and produce energy. In type 2 diabetes, once known as "adult-onset" diabetes, the body becomes resistant to the effects of insulin or doesn't make enough in Continue reading >>

Management Of Type 2 Diabetes In Youth: An Update

Management Of Type 2 Diabetes In Youth: An Update

Management of Type 2 Diabetes in Youth: An Update KEVIN PETERSON, MD, MPH, University of Minnesota Medical School, Minneapolis, Minnesota JANET SILVERSTEIN, MD, University of Florida College of Medicine, Gainesville, Florida FRANCINE KAUFMAN, MD, Childrens Hospital Los Angeles and Keck School of Medicine of the University of Southern California, Los Angeles, California ELIZABETH WARREN-BOULTON, RN, MSN, Hager Sharp, Washington, D.C. Am Fam Physician.2007Sep1;76(5):658-664. Patient information: See related handout on type 2 diabetes in youth , written by the authors of this article. This article exemplifies the AAFP 2007 Annual Clinical Focus on management of chronic illness. Although type 1 diabetes historically has been more common in patients eight to 19 years of age, type 2 diabetes is emerging as an important disease in this group. Type 2 diabetes accounts for 8 to 45 percent of new childhood diabetes. This article is an update from the National Diabetes Education Program on the management of type 2 diabetes in youth. High-risk youths older than 10 years have a body mass index greater than the 85th percentile for age and sex plus two additional risk factors (i.e., family history, high-risk ethnicity, acanthosis nigricans, polycystic ovary syndrome, hypertension, or dyslipidemia). Reducing overweight and impaired glucose tolerance with increased physical activity and healthier eating habits may help prevent or delay the development of type 2 diabetes in high-risk youths. The American Academy of Pediatrics does not recommend population-based screening of high-risk youths; however, physicians should closely monitor these patients because early diagnosis may be beneficial. The American Diabetes Association recommends screening high-risk youths every two years with a fa Continue reading >>

Understanding The Rising Incidence Of Type 2 Diabetes In Adolescence

Understanding The Rising Incidence Of Type 2 Diabetes In Adolescence

The definition of diabetes mellitus (DM) was recently changed by the American Diabetes Association to a fasting plasma glucose value of at least 126 mg/dl (6.9 mmol/l), on the basis of increased risk of the complication of retinopathy.1 It has been estimated that worldwide approximately 154 million people have diabetes,2 with up to one third of the cases remaining undiagnosed in developed countries such as the USA.3 Its human cost is considerable with morbidity from retinopathy, neuropathy, renal failure, and vascular disease, in addition to the socioeconomic burden. Additional lifetime health costs attributable to DM have been estimated at £19 649 per affected individual in the UK.4 Since the introduction of insulin therapy, a clear distinction has been established between the form of DM where insulin is immediately needed (type 1 or insulin dependent DM), and that where there is a danger of hypoglycaemia, where insulin therapy represents a “luxury” (type 2 diabetes (T2D) or non-insulin dependent DM). The latter is far more frequently associated with obesity and a “gluttonous appetite”.5 Age is a distinguishing feature: an age ⩾40 years predicts T2D with a sensitivity of 97% and a specificity of 100%.6 However, nearly 25 years ago, North American authors first drew attention to the occurrence of T2D in young Pima Indians.7 Pinhas-Hamiel from Cincinnati highlighted the incidence of this condition in black adolescents;8 subsequently Hispano-American adolescents have been found to be affected. This concerned US health authorities sufficiently for the Centers for Disease Control and Prevention to order a specific committee to investigate.10 EPIDEMIOLOGY In greater Cincinnati, the incidence of T2D among young people suddenly increased from 0.3–1.2/100 000 new c Continue reading >>

Diabetes Diagnoses Rising In Youth, Especially Among Minorities

Diabetes Diagnoses Rising In Youth, Especially Among Minorities

Type 1 diabetes diagnoses have risen rapidly for Hispanic youth in comparison to other racial and ethnic groups, a recent study finds. The issue: Chronic illnesses such as diabetes present ongoing challenges to healthcare providers, insurers and the general public. Previous research on American healthcare spending suggests diabetes is the nation’s costliest illness, with expenditures reaching approximately $101.4 billion in 2013. The prevalence of diabetes is increasing for Americans of all ages, partly because of growing national obesity rates. Obesity and type 2 diabetes, which is characterized by an inability to effectively produce and use insulin the body makes to manage blood glucose levels, are linked. Type 1 diabetes is characterized by the body’s lack of insulin due to autoimmune attacks on beta cells in the pancreas. Though diagnoses of both type 1 and type 2 diabetes are on the rise, there are variations in how different groups are affected by this broader trend. A new study suggests that the incidence of type 1 and type 2 diabetes has increased for minority youths more than for their non-Hispanic white peers. An academic study worth reading: “Incidence Trends of Type 1 and Type 2 Diabetes Among Youths, 2002-2012,” published in The New England Journal of Medicine, 2017. About the study: A team led by Elizabeth J. Mayer-Davis from the University of North Carolina at Chapel Hill examined data from the national SEARCH for Diabetes in Youth study, which comprised 11,245 youths with type 1 diabetes and 2,846 with type 2 diabetes. The researchers sought to better understand specific trends in diagnosis rates of diabetes in youth. For inclusion in the SEARCH study, subjects had to be younger than 20 years old and diagnosed by a physician. Data was collected p Continue reading >>

Type 2 Diabetes Statistics And Facts

Type 2 Diabetes Statistics And Facts

Type 2 diabetes is the most common form of diabetes. Read on to learn some of the key facts and statistics about the people who have it and how to manage it. Risk factors Many risk factors for type 2 diabetes include lifestyle decisions that can be reduced or even cut out entirely with time and effort. Men are also at slightly higher risk of developing diabetes than women. This may be more associated with lifestyle factors, body weight, and where the weight is located (abdominally versus in the hip area) than with innate gender differences. Significant risk factors include: older age excess weight, particularly around the waist family history certain ethnicities physical inactivity poor diet Prevalence Type 2 diabetes is increasingly prevalent but also largely preventable. According to the Centers for Disease Control and Prevention (CDC), type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. The CDC also gives us the following information: In general Research suggests that 1 out of 3 adults has prediabetes. Of this group, 9 out of 10 don't know they have it. 29.1 million people in the United States have diabetes, but 8.1 million may be undiagnosed and unaware of their condition. About 1.4 million new cases of diabetes are diagnosed in United States every year. More than one in every 10 adults who are 20 years or older has diabetes. For seniors (65 years and older), that figure rises to more than one in four. Cases of diagnosed diabetes cost the United States an estimated $245 billion in 2012. This cost is expected to rise with the increasing diagnoses. In pregnancy and parentingAccording to the CDC, 4.6 to 9.2 percent of pregnancies may be affected by gestational diabetes. In up to 10 percent of them, the mother is diagnosed w Continue reading >>

Type 2 Diabetes In Youth: Epidemiology And Pathophysiology

Type 2 Diabetes In Youth: Epidemiology And Pathophysiology

Type 2 Diabetes in Youth: Epidemiology and Pathophysiology We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Type 2 Diabetes in Youth: Epidemiology and Pathophysiology The prevalence of type 2 diabetes is significantly increased in the pediatric population, which is affected by obesity worldwide. The progression from normal glucose tolerance (NGT) to type 2 diabetes involves intermediate stages of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), also known as prediabetes. The pathophysiology underlying the development of these glucose metabolic alterations is multifactorial; however an alteration in the balance between insulin sensitivity and insulin secretion represents the most important player in the development of type 2 diabetes. Obese children and adolescents affected by IGT and type 2 diabetes are characterized by severe insulin resistance, which is associated with an increased lipid accumulation in visceral compartments, liver and muscle tissues and by reduced sensitivity of -cell of first and second-phase insulin secretion. The progression in obese children of insulin resistance to type 2 diabetes has been shown to be faster than in adults; in addition, type 2 diabetes is already associated with several metabolic and cardiovascular complications in this age group. In the present review, we summarize the most recent findings concerning the prevalence of type 2 diabetes in youth and in particular we expl Continue reading >>

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