Prediabetes and type 2 diabetes in youth: an... : Current Opinion in Endocrinology, Diabetes & Obesity (original) (raw)

Diabetes and the endocrine pancreas: Edited by Allison B. Goldfine

Prediabetes and type 2 diabetes in youth: an emerging epidemic disease?

Anna MG Cali
Sonia Caprio

Current Opinion in Endocrinology, Diabetes & Obesity

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123

127

April 2008

| DOI: 10.1097/MED.0b013e3282f57251

Purpose of review

The prevalence of obesity in youth is increasing alarmingly among children and adolescents in the United States. The problem falls disproportionately on African-American and Hispanic children. Many of the metabolic and cardiovascular complications associated with obesity are already present during childhood and are closely linked to the concomitant insulin resistance/hyperinsulinemia and degree of obesity. Moreover, these co-morbidities persist into adulthood.

Recent findings

The progression from normal glucose tolerance to type 2 diabetes mellitus involves an intermediate stage known as prediabetes or impaired glucose regulation. Prediabetes is characterized by peripheral insulin-resistance and impaired glucose sensitivity of first-phase insulin secretion. On the other hand, in overt type 2 diabetes mellitus β-cell failure becomes fully manifested. Progression from prediabetes to type 2 diabetes mellitus in youth is characterized by marked weight gain and further reduction in insulin secretion and insulin resistance.

Summary

Reverting obesity through lifestyle modification, that involves nutrition education, behavior modification and exercise, is an important step to prevent the progression to diabetes.