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Youth onset diabetes

The incidence of youth onset type diabetes has increased in parallel with the rise of the number of children with obesity in the United States.

The prevalence of type two diabetes in children and adolescents has increased over the last two decades, among youth age 10-19 by 95% in 16 years.

In recent years the incidence of type two diabetes has increased by 4.8% each year.

The development of insulin resistance and deterioration in beta cell function, progress more rapidly in youth onset type two diabetes than in adult onset diabetes.

Contributors to youth onset type two diabetes include: obesity, high fat/high carbohydrate diet, physical inactivity, and a family history of diabetes; all factors they tend to cluster in the US by socioeconomic status.

Type two diabetes in childhood is associated with higher morbidity and premature mortality due to accelerated onset and progression of microvascular and macrovascular complications.

Such complications are at higher rates and younger ages in patients with youth onset type two diabetes than those with youth onset type one diabetes or in adults diagnosed with type two diabetes.

Youth onset diabetes is associated with worse glycemic control and an increased risk of early diabetes related complications.

In a Manitoba review there was a higher prevalence of diabetic kidney disease, hypertension, retinal disease, and peripheral nerve disease among youths with type two diabetes than among those with type one diabetes.

Among participants with onset of type two diabetes in youth, the risk of complications including,  microvascular complications, increased steadily overtime and affected most participants by the time of young adulthood.

 

Complications are more common among minority races and ethnic groups and among those with hyperglycemia, hypertension and dyslipidemia.

Type two diabetes of youth onset has a more indolent course and may come to clinical attention after a prolonged period of dysglycemia.

This period of dysglycemia or prediabetes includes impaired fasting glucose or impaired glucose tolerance.

 

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