Type 2 Diabetes, Metabolic Syndrome and Lipid Metabolism (original) (raw)

This year, a 5-year-old girl became one of the youngest individuals diagnosed with type 2 diabetes (T2DM). A study from the USA revealed an overall prevalence of T2DM of 0.36%, including an estimated 120,000 adolescents, about one third of whom are undiagnosed. These numbers are alarming considering findings on the safety and tolerability of current treatments for youth with T2DM and the recent finding of high rates of morbidity and mortality. Interestingly, glycemic control alone was found to be insufficient to attenuate the excess risk in T2DM. Evidence suggests that features of the metabolic syndrome (MetS) may be involved in the pathogenesis of co-morbidities. Genetic mutations causing an inherited form of the MetS were identified, with implications for drug development across diabetes, heart disease, and obesity. Metformin was found to increase lifespan by altering microbial folate and methionine metabolism. The 2013 guidelines of the American College of Cardiology and American Heart Association (ACC-AHA) for the management of cholesterol, released in November, are reviewed, as well as a comment on the controversies that emerged after their publication regarding their implications for public health. The results of 1-year treatment with a PCSK9 inhibitor are reviewed, as well as the results of a trial of mipomersen, a new second-generation apolipoprotein B antisense oligonucleotide. Finally, the effect of 'an apple a day' versus statin therapy is compared.