Type 2 Diabetes Mellitus in Children and Adolescents

Dileepan, Kavitha; Feldt, Matthew M

doi:10.1542/pir.34-12-541

Cited by 22 publications

(18 citation statements)

References 27 publications

(2 reference statements)

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“…Although the development of T2DM is still more common in adults, an increase in this disease has been reported in children and adolescents [40]. Although genetic factors predispose individuals to the development of diabetes, obesity, lifestyle, poor living conditions, and social factors further contribute to it [41].…”

Section: Discussionmentioning

confidence: 99%

Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity

et al. 2014

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BackgroundThe beneficial effects of the Mediterranean diet have been amply proven in adults with cardiovascular risk factors. The effects of this diet have not been extensively assessed in pediatric populations with obesity, insulin resistance (IR) and metabolic syndrome (MetS). The aim of this study was to assess the efficacy of the Mediterranean style diet (MSD) to decrease cardiovascular risk factors in children and adolescents with obesity.MethodsParticipants were randomly assigned to a MSD rich in polyunsaturated fatty acids, fiber, flavonoids and antioxidants (60% of energy from carbohydrate, 25% from fat, and 15% from protein, (n = 24); or a standard diet (55% of carbohydrate, 30% from fat and 15% from protein, (n = 25), the caloric ingest was individualized. At baseline and 16-week of intervention, the glucose, triglycerides (TG), total cholesterol (TC), HDL-C, LDL-C were measured as well as the body composition and anthropometric data. The diet compliance was determined by the 24-hour recalls.Paired Student’s t and Macnemar’s test were used to compare effects in biochemical, body composition, anthropometric, and dietary variables.ResultsThe MSD group had a significantly decrease in BMI, lean mass, fat mass, glucose, TC, TG, HDL-C and LDL-C. (p < 0.05); the diet compliance increased consumption of omega 9 fatty acids, zinc, vitamin E, selenium, and decreased consumption of saturated fatty acids (p < 0.05). The standard diet group decrease in glucose levels and frequency of glucose >100 mg/dL (p < 0.05).ConclusionThe MSD improves the BMI, glucose and lipid profile in children and adolescents with obesity and any MetS component.

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Section: Discussionmentioning

confidence: 99%

Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity

et al. 2014

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“…Recent advancement in stem cell research and the feasibility to differentiate human adipose-derived stem cells (hADSCs) to white and brown adipocytes have made hADSC as a desired model to study adipocyte biology (DeLany et al 2005). Obese prediabetic subjects have been reported to have 400-600 pM/L serum insulin and 7-11 mmol/L of blood glucose (Dileepan & Feldt 2013). Recently, Guanfeng Xu and coworkers exposed human primary adipocytes to 600 pM insulin/25 mM glucose for 48 h to induce insulin resistance (Xu et al 2015).…”

Section: Figurementioning

confidence: 99%

Chronic hyperinsulinemia reduces insulin sensitivity and metabolic functions of brown adipocyte

Rajan

Shankar

Beg

et al. 2016

Journal of Endocrinology

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The growing pandemics of diabetes have become a real threat to world economy. Hyperinsulinemia and insulin resistance are closely associated with the pathophysiology of type 2 diabetes. In pretext of brown adipocytes being considered as the therapeutic strategy for the treatment of obesity and insulin resistance, we have tried to understand the effect of hyperinsulinemia on brown adipocyte function. We here with for the first time report that hyperinsulinemia-induced insulin resistance in brown adipocyte is also accompanied with reduced insulin sensitivity and brown adipocyte characteristics. CI treatment decreased expression of brown adipocyte-specific markers (such as PRDM16, PGC1α, and UCP1) and mitochondrial content as well as activity. CI-treated brown adipocytes showed drastic decrease in oxygen consumption rate (OCR) and spare respiratory capacity. Morphological study indicates increased accumulation of lipid droplets in CI-treated brown adipocytes. We have further validated these findings in vivo in C57BL/6 mice implanted with mini-osmotic insulin pump for 8 weeks. CI treatment in mice leads to increased body weight gain, fat mass and impaired glucose intolerance with reduced energy expenditure and insulin sensitivity. CI-treated mice showed decreased BAT characteristics and function. We also observed increased inflammation and ER stress markers in BAT of CI-treated animals. The above results conclude that hyperinsulinemia has deleterious effect on brown adipocyte function, making it susceptible to insulin resistance. Thus, the above findings have greater implication in designing approaches for the treatment of insulin resistance and diabetes via recruitment of brown adipocytes.

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“…However, increasing incidence of T2DM in children and adolescents has been noted in both developed and developing countries in recent decades [1–4]. Previous reports of T2DM focused primarily on ethnic minority groups, specialized clinical population, and high risk population in specific geographic locations [5–7].…”

Section: Introductionmentioning

confidence: 99%

Incidence and time trends of type 2 diabetes mellitus in youth aged 5–19 years: a population-based registry in Zhejiang, China, 2007 to 2013

Zhong

et al. 2017

BMC Pediatr

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BackgroundThe incidence of type 2 diabetes mellitus (T2DM) has been increasing globally over the past two decades in children and adolescents. There are currently a dearth of comprehensive population-based estimates of T2DM incidence and time trends in Chinese youth.MethodsA population-based diabetes registry system in 30 representative districts in Zhejiang has been established for diabetes surveillance. All newly cases diagnosed by physicians in local hospitals and wards were registered using the registry system through web services and direct network report. The data were primarily abstracted from medical records in hospitals and wards. Annual incidence rates and their 95% confidence intervals (CIs) by age groups and sex were calculated per 100 000 person-years. Poisson regression models were applied to assess the effects of diagnosis year, age groups, sex and residence area on T2DM incidence and to examine the average annual percentage change in incidence.ResultsThere were 392 newly diagnosed cases of T2DM (210 boys and 182 girls) over the study period. The mean annual age-standardized incidence was 1.96/100 000 person-years (95% CIs: 1.85–2.08). No statistically significant difference in incidence was found between boys and girls. However, the risk for T2DM was 1.49 times higher in urban area than in rural area. Besides, the mean annual incidence in youth increased with age. The age-standardized incidence was about 5 times higher in 2013 than in 2007. Steep rising incidence was observed, with an average annual increase of 26.6% in youth aged 10–19 years.ConclusionsThe incidence of T2DM in children and adolescents was low in Zhejiang relative to other countries, whereas it increased markedly over the study period. Preventive strategies for T2DM are necessary in pediatric population.

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Type 2 Diabetes Mellitus in Children and Adolescents

Cited by 22 publications

References 27 publications

Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity

Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity

Chronic hyperinsulinemia reduces insulin sensitivity and metabolic functions of brown adipocyte

Incidence and time trends of type 2 diabetes mellitus in youth aged 5–19 years: a population-based registry in Zhejiang, China, 2007 to 2013

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