Youth-Onset Type 2 Diabetes: What We've Learned From Key Youth-Onset Type 2 Diabetes Studies, What We Still Don't Know, and Why It Is Important.

Abstract

In this review, we describe the epidemiology, pathophysiology, pediatric-specific treatment response data, morbidity, and mortality of youth-onset type 2 diabetes. In recognition of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 75th anniversary, the focus is primarily on data from three landmark youth-onset type 2 diabetes studies funded by the NIDDK in the last 20+ years. We discuss the now-recognized aggressive clinical course of youth-onset type 2 diabetes, which only recently became appreciated as a pediatric disease among health care providers. We highlight the similarities and differences between youth-onset and adult-onset type 2 diabetes, in particular how type 2 diabetes in youth appears to have an accelerated clinical course with earlier onset of complications in comparison with adult-onset type 2 diabetes; how these findings influenced the care and treatment recommendations for youth with type 2 diabetes; and how the many lessons from these studies, in turn, highlight remaining unanswered questions. We feature recent findings regarding long-term follow-up of diabetes complications in these youth, and how they differ from youth with type 1 diabetes. Finally, we conclude with an overview of emerging studies and topics in type 2 diabetes research that have potential to inform effective preventive action strategies.