Incidence and prevalence trends of youth-onset type 2 diabetes in a cohort of Canadian youth: 2002-2013

Amed, Shazhan; Islam, Nazrul; Sutherland, Jennifer; Reimer, Kim

doi:10.1111/pedi.12631

Cited by 31 publications

(27 citation statements)

References 27 publications

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“…Epidemic obesity has resulted in a rapid increase of type 2 diabetes (T2D) in children . However, the pathways linking childhood obesity to T2D remain poorly characterized, and prediction and prevention of T2D are unfulfilled aspirations.…”

Section: Introductionmentioning

confidence: 99%

Insulin Resistance during normal child growth and development is associated with a distinct blood metabolic phenotype (Earlybird 72)

et al. 2019

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Background While insulin resistance (IR) is associated with specific metabolite signatures in adults, there have been few truly longitudinal studies in healthy children, either to confirm which abnormalities are present, or to determine whether they precede or result from IR. Therefore, we investigated the association of serum metabolites with IR in childhood in the Earlybird cohort. Methods The Earlybird cohort is a well‐characterized cohort of healthy children with annual measurements from age 5 to 16 years. For the first time, longitudinal association analyses between individual serum metabolites and homeostatic model assessment (HOMA) of insulin resistance (HOMA‐IR) have been performed taking into account the effects of age, growth, puberty, adiposity, and physical activity. Results IR was higher in girls than in boys and was associated with increasing body mass index (BMI). In longitudinal analysis IR was associated with reduced concentrations of branched‐chain amino acids (BCAA), 2‐ketobutyrate, citrate and 3‐hydroxybutyrate, and higher concentrations of lactate and alanine. These findings demonstrate the widespread biochemical consequences of IR for intermediary metabolism, ketogenesis, and pyruvate oxidation during normal child growth and development. Conclusions Longitudinal analysis can differentiate metabolite signatures that precede or follow the development of greater levels of IR. In healthy normal weight children, higher levels of IR are associated with reduced levels of BCAA, ketogenesis, and fuel oxidation. In contrast, elevated lactate concentrations preceded the rise in IR. These changes reveal the metabolite signature of insulin action during normal growth, and they contrast with previous findings in obese children and adults that represent the consequences of IR and obesity.

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Section: Introductionmentioning

confidence: 99%

Insulin Resistance during normal child growth and development is associated with a distinct blood metabolic phenotype (Earlybird 72)

et al. 2019

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“…In total, approximately 193 000 Americans under the age of 20 are living with diabetes, with ~17 900 and 5300 annually diagnosed with type 1 and type 2 diabetes, respectively . The prevalence of type 2 diabetes, moreover, is increasing among U.S. adolescents, and is driven by increases in body mass index (BMI) during childhood and adolescence, as well as by social and behavioral factors …”

Section: Introductionmentioning

confidence: 99%

Risk factors for diabetes are higher among non-heterosexual US high-school students

et al. 2018

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Low physical activity (PA), high sedentary behavior (SB), and overweight and obesity have been shown to associate with increased Type 2 diabetes risk among adolescents. We investigated PA, SB, and overweight and obesity among Youth Risk Behavior Survey (YRBS) respondents to determine if non-heterosexual youth may be at increased diabetes risk compared to heterosexual youth. Weighted city and state YRBS data were pooled across 44 jurisdictions biennially from 2009 to 2015, resulting in a sample size of 350 673 students. Overall, 88.4% identified as heterosexual, 2.1% as gay or lesbian, 5.7% as bisexual, and 3.7% as unsure. With the exception of lesbian female students, after adjusting for age, race/ethnicity, body mass index, and survey year, all non-heterosexual youth reported significantly fewer days per week of PA compared to their sex-matched heterosexual counterparts. Similarly, compared to heterosexual female youth, bisexual and not sure female youth reported significantly more hours per day of SB. These PA and SB findings remained significant after adjustment for depressive symptoms and in-school bullying among bisexual female youth only. In fully adjusted models, lesbian students were 1.85 times more likely to be overweight and lesbian, bisexual, and not sure female youth were 1.55 to 2.07 times more likely to be obese than heterosexual female students. No significant differences in SB, overweight, or obesity were found among gay, bisexual, or unsure male youth compared to heterosexual male youth. Non-heterosexual youth may be at increased risk for developing type 2 diabetes mellitus compared to heterosexual youth. Future studies should characterize diabetes prevalence among non-heterosexual youth.

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“…Worldwide prevalence of diabetes is expected to increase to 7.7% or 439 million adults by 2030, with developing countries bearing most of the increase in burden of the disease . Moreover, there is evidence to suggest diabetes mellitus type 2 is in increasing in incidence over the past decade in youth, even in developed countries …”

Section: Underutilization Of Statins In Eligible Diabetic Populationsmentioning

confidence: 99%

“…56 Moreover, there is evidence to suggest diabetes mellitus type 2 is in increasing in incidence over the past decade in youth, even in developed countries. 57 Guideline directed therapy is still being underutilized. Observational data from healthcare databases of representative population from Germany showed only about 27% of patients with diabetes mellitus type 2 were receiving medications to treat dyslipidemia.…”

Section: Underutilization Of Statins In Eligible Diabetic Populationsmentioning

confidence: 99%

The extent to which statins have improved cardiovascular outcomes: Lessons from randomized trials and observational studies of “real world” practice in people with diabetes

Jayanna

Robinson

2019

Diabetes Obesity Metabolism

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Statins are the mainstay of therapy for cardiovascular risk reduction in patients with diabetes mellitus. It is estimated that there are more than half a billion patients with diabetes mellitus worldwide and the numbers of prevalent cases of diabetes are expected to increase in both developed and developing countries in the next decade. Statins reduce risk of mortality and morbidity mainly by reducing blood low density cholesterol. Statins, along with other medical treatments, are responsible for about half of the decrease in cardiovascular mortality over the past several decades. Multiple clinical trials have found evidence for statin use in patients with diabetes, for both primary prevention and secondary prevention. The benefit of statins in patients with coronary heart disease and diabetes in terms of absolute risk reduction is twice as much as compared to the risk in patients with coronary heart disease but no diabetes. The proportion of patients with diabetes treated with statins has increased steadily over the past few decades with concurrent decrease in cardiovascular deaths in this high‐risk population. However, there are significant unmet needs in cardiovascular risk reduction, due to underutilization of statins and due to residual cardiovascular risk despite maximal statin therapy. Future strategies in population risk reduction in diabetics should include maximal statin therapy, additional treatment with nonstatin therapy and new paradigms of prevention with early intervention with shorter, more intensive therapy to potentially “reverse” atherosclerosis with goals of reducing clinical cardiovascular disease later in life.

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Incidence and prevalence trends of youth-onset type 2 diabetes in a cohort of Canadian youth: 2002-2013

Abstract: Youth-onset type 2 diabetes is increasing with higher rates in females vs males. If these rates continue, in 2030, the number of cases will increase by 5-fold. These data are needed to set priorities for diabetes prevention in youth.

Cited by 31 publications

References 27 publications

Insulin Resistance during normal child growth and development is associated with a distinct blood metabolic phenotype (Earlybird 72)

Insulin Resistance during normal child growth and development is associated with a distinct blood metabolic phenotype (Earlybird 72)

Risk factors for diabetes are higher among non-heterosexual US high-school students

The extent to which statins have improved cardiovascular outcomes: Lessons from randomized trials and observational studies of “real world” practice in people with diabetes

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