Youth-onset type 2 diabetes mellitus: an urgent challenge

Petter Bjornstad, Lily C. Chao, Melanie Cree-Green, Allison B. Dart, Malcolm King, Helen C. Looker, Dianna J. Magliano, Kristen J. Nadeau, Orit Pinhas-Hamiel, Amy S. Shah, Daniel H. van Raalte, Meda E. Pavkov, Robert G. Nelson*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

41 Scopus citations

Abstract

The incidence and prevalence of youth-onset type 2 diabetes mellitus (T2DM) and its complications are increasing worldwide. Youth-onset T2DM has been reported in all racial and ethnic groups, but Indigenous peoples and people of colour are disproportionately affected. People with youth-onset T2DM often have a more aggressive clinical course than those with adult-onset T2DM or those with type 1 diabetes mellitus. Moreover, the available treatment options for children and adolescents with T2DM are more limited than for adult patients. Intermediate complications of youth-onset T2DM, such as increased albuminuria, often develop in late childhood or early adulthood, and end-stage complications, including kidney failure, develop in mid-life. The increasing frequency, earlier onset and greater severity of childhood obesity in the past 50 years together with increasingly sedentary lifestyles and an increasing frequency of intrauterine exposure to diabetes are important drivers of the epidemic of youth-onset T2DM. The particularly high risk of the disease in historically disadvantaged populations suggests an important contribution of social and environmental factors, including limited access to high-quality health care, healthy food choices and opportunities for physical activity as well as exposure to stressors including systemic racism and environmental pollutants. Understanding the mechanisms that underlie the development and aggressive clinical course of youth-onset T2DM is key to identifying successful prevention and management strategies.

Original languageEnglish
Pages (from-to)168-184
Number of pages17
JournalNature Reviews Nephrology
Volume19
Issue number3
DOIs
StatePublished - Mar 2023

Funding

FundersFunder number
Department of Paediatrics, Section of Endocrinology and Barbara Davis Center for Diabetes at University of Colorado School of Medicine
Centers for Disease Control and Prevention
National Heart, Lung, and Blood InstituteR01 HL165433
National Institute of Diabetes and Digestive and Kidney DiseasesP30 DK116073, K23 DK116720, R21 DK129720, UC DK114886, R01 DK132399, R01 DK129211
National Institute of Neurological Disorders and StrokeR01 NS125316
American Heart Association20IPA35260142
Boettcher Foundation
Juvenile Diabetes Research Foundation United States of America2-SRA-2019-845-S-B
Diabetes FondsK24 HL145076, R01 DK119450, R01 HL157260

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