ADA Releases Comprehensive Type 2 Diabetes Guidelines for Youth

There are fundamental differences in the pathogenesis and course of type 2 diabetes between young people and adults that necessitate a different approach in youth¬†with the disease, with an emphasis on the patient’s social context and long-term management, say experts in a new position statement.

Writing on behalf of the American Diabetes Association (ADA), the authors developed guidelines on the pathogenesis, risk assessment, diagnostic criteria, and management of type 2 diabetes in young individuals, as well as associated comorbidities and complications and the transition to adult care.

They stress the need for risk-based screening in overweight and obese children and the development of culturally and contextually sensitive education and lifestyle management programs, particularly given the demographic profile of young patients with type 2 diabetes.

The statement, published online November 13 in Diabetes Care, was issued as the incidence of type 2 diabetes in the United States is estimated to have increased by 4.8% in people aged under 20 years in the decade between 2002 and 2012.

Type 2 diabetes also “appears to be more aggressive in youth than in adults, with a faster rate of deterioration of beta-cell function and poorer response to glucose-lowering medication,” lead author Silva Arslanian, MD, from the University of Pittsburgh, Pennsylvania, said in an ADA news release.

“Furthermore, there is a higher risk for complications in people with earlier-onset type 2 diabetes, which is possibly related to prolonged lifetime exposure to hyperglycemia and other atherogenic risk factors, including insulin resistance, dyslipidemia, hypertension, and chronic inflammation.”

Arslanian therefore urges¬†clinicians to “continue to make strides in recognizing the specific needs of youth and adolescents who are at risk or diagnosed with type 2 diabetes.”

Youth-Onset Type 2 Diabetes Is Different

William T. Cefalu, MD, chief scientific, medical, and mission officer at the ADA, who was not involved in developing the statement, echoed those comments.

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