Highlights & Basics
- Type 2 diabetes in children usually presents after the onset of puberty, at a mean age of 14 years, with obesity being the primary cause.
- Often asymptomatic and diagnosed by screening in a high-risk individual (e.g., family history, obesity, acanthosis nigricans) or incidentally (e.g., glycosuria found during a school or sports exam).
- The development of insulin resistance and glucose intolerance can be prevented or delayed by lifestyle modifications that correct obesity in children.
- Goals of treatment are to promote weight loss and exercise capacity, normalize glycemia and hemoglobin A1c (goal is <6.5% [<48 mmol/mol]), and prevent long-term complications and comorbidities (e.g., retinopathy, hypertension, and dyslipidemia).
- Initial treatment includes lifestyle modifications, metformin, and insulin. Glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors are approved in some countries as an additional non-insulin treatment option for children ages ≥10 years.
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Citations
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Glaser N, Fritsch M, Priyambada L, et al. ISPAD clinical practice consensus guidelines 2022: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2022 Nov;23(7):835-56.[Abstract]
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