ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents

Mayer‐Davis, Elizabeth J.; Kahkoska, Anna R.; Jefferies, Craig; Dabelea, Dana; Baldé, N.M.; Gong, Chun; Aschner, Pablo; Craig, Maria E.

doi:10.1111/pedi.12773

Cited by 476 publications

(461 citation statements)

References 180 publications

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“…Symptoms specific to young people include unexplained weight loss, growth impairment, and bed wetting (online suppl. Table S2) [8,9]. These true diabetes-related symptoms are rather unspecific in nature.…”

Section: Resultsmentioning

confidence: 99%

“…Table S2) [1,8,9]. Symptoms specific to young people include unexplained weight loss, growth impairment, and bed wetting (online suppl.…”

Section: Resultsmentioning

confidence: 99%

“…Although a susceptibility to certain infections can accompany chronic hyperglycemia [9], this association may be overlooked in gynecological infections. When a girl presents with such an infection, the HCP should consider the presence of T2D.…”

Section: Less-known Comorbid Associations With Youth-onset T2dmentioning

confidence: 99%

“…1), a diagnostic blood test is needed [8,14,66], followed by a type-distinguishing test [8]. Symptoms of diabetes plus random plasma glucose concentration ≥11.1 mmol/L (200 mg/dL), or glycated hemoglobin (HbA 1c ; ≥6.5%, 48 mmol/mol), or fasting plasma glucose (FPG; ≥7.0 mmol/L, 126 mg/dL), or 2 h plasma glucose during an oral glucose tolerance test (≥11.1 mmol/L, 200 mg/dL) may be used for diagnosing diabetes of either type [9,14]. There is, however, debate as to the suitability of HbA 1c [14,67], particularly the precise value to use, with some suggesting that lower than the 6.5% currently recommended in adults should be used [67].…”

Section: Diagnostic Tests For Youth-onset T2dmentioning

confidence: 99%

“…These HCPs screen for diabetes regularly, but sometimes patients may be asymptomatic or mildly symptomatic for youth-onset T2D [7,8], or present with another condition obscuring T2D [4]. While there are classic symptoms and risk factors of youth-onset T2D [8,9], there are several other manifestations that could indicate whether it is appropriate to screen for this disease (Table 1).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Youth-Onset Type 2 Diabetes Manifestations in other Specialties: Its Many Disguises

2019

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Background: Youth-onset type 2 diabetes (T2D) is increasing in many countries, creating large personal and societal burdens. While many primary health-care professionals (HCPs) are aware of the classic symptoms of T2D, there are several other manifestations that could indicate its presence. Summary: This narrative review summarizes information on these symptoms and indicators, focusing on those less well known. The classic symptoms and comorbidities include frequent urination, excessive thirst, metabolic syndrome, and obesity. In addition to these, the presence of dermatological (e.g., acanthosis nigricans, granuloma annulare, necrobiosis lipoidica diabeticorum, and scleredema), gynecological (e.g., polycystic ovary syndrome, oligomenorrhea, and vulvovaginitis), hepatological (e.g., nonalcoholic fatty liver disease), and psychiatric diseases (e.g., psychosis, depression, and autism) could indicate that a patient has T2D or is at increased risk of T2D. Other less well-known indicators include abnormal blood tests (e.g., oxidized lipids, inflammation markers, hepatokines, and adipokines), prescriptions for antipsychotic medications or statins, and disrupted sleep patterns. Key Message: Due to the diversity of T2D manifestations in young people, primary HCPs need to remain alert to its possible presence.

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Section: Resultsmentioning

confidence: 99%

“…Table S2) [1,8,9]. Symptoms specific to young people include unexplained weight loss, growth impairment, and bed wetting (online suppl.…”

Section: Resultsmentioning

confidence: 99%

Section: Less-known Comorbid Associations With Youth-onset T2dmentioning

confidence: 99%

Section: Diagnostic Tests For Youth-onset T2dmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Youth-Onset Type 2 Diabetes Manifestations in other Specialties: Its Many Disguises

2019

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Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017

Lawrence

Divers

Isom

et al. 2021

JAMA

Self Cite

291

203

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IMPORTANCEChanges in the prevalence of youth-onset diabetes have previously been observed.OBJECTIVE To estimate changes in prevalence of type 1 and type 2 diabetes in youths in the US from 2001 to 2017. DESIGN, SETTING, AND PARTICIPANTSIn this cross-sectional observational study, individuals younger than 20 years with physician-diagnosed diabetes were enumerated from 6 areas in the US (4 geographic areas, 1 health plan, and select American Indian reservations) for 2001, 2009, and 2017. EXPOSURES Calendar year. MAIN OUTCOMES AND MEASURES Estimated prevalence of physician-diagnosed type 1 and type 2 diabetes overall and by race and ethnicity, age, and sex. RESULTS Among youths 19 years or younger, 4958 of 3.35 million had type 1 diabetes in 2001, 6672 of 3.46 million had type 1 diabetes in 2009, and 7759 of 3.61 million had type 1 diabetes in 2017; among those aged 10 to 19 years, 588 of 1.73 million had type 2 diabetes in 2001, 814 of 1.85 million had type 2 diabetes in 2009, and 1230 of 1.85 million had type 2 diabetes in 2017. The estimated type 1 diabetes prevalence per 1000 youths for those 19 years or younger increased significantly from 1.48 (95% CI, 1.44-1.52) in 2001 to 1.93 (95% CI, 1.88-1.98) in 2009 to 2.15 (95% CI, 2.10-2.20) in 2017, an absolute increase of 0.67 per 1000 youths (95%, CI, 0.64-0.70) and a 45.1% (95% CI, 40.0%-50.4%) relative increase over 16 years. The greatest absolute increases were observed among non-Hispanic White (0.93 per 1000 youths [95% CI, 0.88-0.98]) and non-Hispanic Black (0.89 per 1000 youths [95% CI, 0.88-0.98]) youths. The estimated type 2 diabetes prevalence per 1000 youths aged 10 to 19 years increased significantly from 0.34 (95% CI, 0.31-0.37) in 2001 to 0.46 (95% CI, 0.43-0.49) in 2009 to 0.67 (95% CI, 0.63-0.70) in 2017, an absolute increase of 0.32 per 1000 youths (95% CI, 0.30-0.35) and a 95.3% (95% CI, 77.0%-115.4%) relative increase over 16 years. The greatest absolute increases were observed among non-Hispanic Black (0.85 per 1000 youths [95% CI, 0.74-0.97]) and Hispanic (0.57 per 1000 youths [95% CI, 0.51-0.64]) youths. CONCLUSIONS AND RELEVANCEIn 6 areas of the US from 2001 to 2017, the estimated prevalence of diabetes among children and adolescents increased for both type 1 and type 2 diabetes.

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Parental Income Level and Risk of Developing Type 2 Diabetes in Youth

Yen,

Wei,

Liu

et al. 2023

JAMA Netw Open

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ImportanceIn recent years, the global incidence of type 2 diabetes in young people has increased, especially among minoritized, Indigenous, or financially disadvantaged populations. However, few studies have examined whether poverty is associated with increased risk of youth-onset type 2 diabetes.ObjectiveTo examine the association of family income level with the risk of youth-onset type 2 diabetes.Design, Setting, and ParticipantsThis nationwide, population-based retrospective cohort study used data from the 2008 National Health Insurance Research Database of Taiwan, with follow-up through December 31, 2019. Participants included children and adolescents aged 0 to 19 years. Data analysis was performed from June 9, 2022, to January 16, 2023.ExposuresFamily income, classified as very low, low, middle, and high.Main Outcomes and MeasuresCox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the risks of youth-onset type 2 diabetes and all-cause mortality for all income groups vs the high-income group.ResultsThe cohort included a total of 5 182 893 children and adolescents (mean [SD] age, 11.2 [5.2] years; 2 477 807 girls [48.3%]). The mean (SD) follow-up duration was 9.0 (0.3) years. The incidence rates of youth-onset type 2 diabetes were 0.52 cases per 1000 person-years for the very-low-income group, 0.40 cases per 1000 person-years for the low-income group, 0.35 cases per 1000 person-years for the middle-income group, and 0.28 cases per 1000 person-years for the high-income group. Children and adolescents from very-low-income (aHR, 1.55; 95% CI, 1.41-1.71), low-income (aHR, 1.34; 95% CI, 1.27-1.41), and middle-income (aHR, 1.27; 95% CI, 1.20-1.34) families had a significantly higher hazard of youth-onset type 2 diabetes than those from high-income families. Children and adolescents from very-low-income (aHR, 2.18; 95% CI, 1.97-2.41), low-income (aHR, 1.51; 95% CI, 1.42-1.60), and middle-income (aHR, 1.22; 95% CI, 1.14-1.31) families also had a significantly higher hazard of all-cause mortality than those from high-income families. Children and adolescents who were older, female, and obese and had dyslipidemia, gout, or psychiatric disorders had a significantly higher risk of youth-onset type 2 diabetes than children without those characteristics.Conclusions and RelevanceThis population-based cohort study showed that children and adolescents from very-low-income to middle-income families had a higher hazard of youth-onset type 2 diabetes and mortality than those from high-income families. Further research to reveal the factors underlying this association may improve the accuracy of identifying individuals at greatest risk for developing type 2 diabetes in youth.

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ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents

Cited by 476 publications

References 180 publications

Youth-Onset Type 2 Diabetes Manifestations in other Specialties: Its Many Disguises

Youth-Onset Type 2 Diabetes Manifestations in other Specialties: Its Many Disguises

Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017

Parental Income Level and Risk of Developing Type 2 Diabetes in Youth

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