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

Weghuber, Daniel; Barrientos-Pérez, Margarita; Коваренко, Маргарита

doi:10.1159/000500234

Cited by 6 publications

(7 citation statements)

References 58 publications

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“…Several age-at-onset cutoffs have been used to define youth-onset T2D, including #18, <21, and <25 years. We selected <25 years because this age at onset is commonly used by other groups (1, 18,19) and is consistent with the United Nations definition for youth (https://www.un.org/en/global-issues/ youth). We also examined how the parameters of structural injury were related to age at onset as a continuous variable.…”

Section: Youth-onset Versus Adult-onset T2d Ascertainmentmentioning

confidence: 99%

Structural Lesions on Kidney Biopsy in Youth-Onset and Adult-Onset Type 2 Diabetes

et al. 2022

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OBJECTIVE Type 2 diabetes (T2D) is a leading cause of end-stage kidney disease worldwide. Recent studies suggest a more aggressive clinical course of diabetic kidney disease in youth-onset compared with adult-onset T2D. We compared kidney structural lesions in youth- and adult-onset T2D to determine if youth onset was associated with greater early tissue injury. RESEARCH DESIGN AND METHODS Quantitative microscopy was performed on kidney tissue obtained from research kidney biopsies in 161 Pima Indians (117 women, 44 men) with T2D. Onset of T2D was established by serial oral glucose tolerance testing, and participants were stratified as youth onset (age <25 years) or adult onset (age ≥25 years). Associations between clinical and morphometric parameters and age at onset were tested using linear models. RESULTS At biopsy, the 52 participants with youth-onset T2D were younger than the 109 with adult-onset T2D (39.1 ± 9.9 vs. 51.4 ± 10.2 years; P < 0.0001), but their diabetes duration was similar (19.3 ± 8.1 vs. 17.0 ± 7.8 years; P = 0.09). Median urine albumin-to-creatinine ratio was higher in the youth-onset group (58 [25th–75th percentile 17–470] vs. 27 [13–73] mg/g; P = 0.02). Youth-onset participants had greater glomerular basement membrane (GBM) width (552 ± 128 vs. 490 ± 114 nm; P = 0.002) and mesangial fractional volume (0.31 ± 0.10 vs. 0.27 ± 0.08; P = 0.001) than adult-onset participants. Glomerular sclerosis percentage, glomerular volume, mesangial fractional volume, and GBM width were also inversely associated with age at diabetes onset as a continuous variable. CONCLUSIONS Younger age at T2D onset strongly associates with more severe kidney structural lesions. Studies are underway to elucidate the pathways underlying these associations.

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Section: Youth-onset Versus Adult-onset T2d Ascertainmentmentioning

confidence: 99%

Structural Lesions on Kidney Biopsy in Youth-Onset and Adult-Onset Type 2 Diabetes

et al. 2022

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“…AN has been studied in relationship with DM type 2, as part of a larger spectrum underlying IR-MS, and also with DM type 1 [ 87 , 88 , 89 , 90 ]. One study from 2022 on 347 diabetic persons (DM type 1 and 2) identified a prevalence of 71% regarding dermatological lesions aside from infections, pregnancy, cancer, iatrogenic effects, renal failure, and incidental rheumatologic and other endocrine conditions.…”

Section: An and Dmmentioning

confidence: 99%

Acanthosis Nigricans: Pointer of Endocrine Entities

et al. 2022

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Acanthosis nigricans (AN) has been reported in relation to insulin resistance (IR). We aim to review AN through an endocrine and metabolic perspective focusing on IR in association with metabolic complications such as obesity, diabetes mellitus (DM), and metabolic syndrome (MS) with/without polycystic ovary syndrome (PCOS). We revised English papers on PubMed covering publications from the last 5 years. The current prevalence of AN varies from 4.5 to 74% (or even 100%, depending on the studied population), with equal distribution among females and males. Despite higher incidence with an age-dependent pattern, an alarming escalation of cases has been noted for obesity and MS in younger populations . Most frequent IR-associated sites are the neck, axilla, and knuckles, but unusual locations such as the face have also been reported. Quantitative scales such as Burke have been used to describe the severity of the dermatosis, particularly in correlation with IR elements. Dermoscopic examination are required, for instance, in cases with sulcus cutis, hyperpigmented spots, crista cutis, and papillary projections. A skin biopsy may be necessary, but it is not the rule. Both IR that clinically manifests with or without obesity/MS correlates with AN; most studies are cross-sectional, with only a few longitudinal. The approach varied from screening during school periodic checkups/protocols/programs to subgroups of individuals who were already known to be at high cardio-metabolic risk. AN was associated with type2DM, as well as type 1DM. Females with PCOS may already display metabolic complications in 60–80% of cases, with AN belonging to the associated skin spectrum. AN management depends on underlying conditions, and specific dermatological therapy is not generally required, unless the patient achieves metabolic control, has severe skin lesions, or desires cosmetic improvement. In IR cases, lifestyle interventions can help, including weight control up to bariatric surgery. In addition, metformin is a key player in the field of oral medication against DM type 2, a drug whose indication is extended to PCOS and even to AN itself, outside the specific panel of glucose anomalies. In terms of cosmetic intervention, limited data have been published on melatonin, urea cream, topical retinoids, vitamin D analogs, or alexandrite laser. In conclusion, awareness of IR and its associated clinical features is essential to provide prompt recognition of underlying conditions. AN represents a useful non-invasive surrogate marker of this spectrum in both children and adults. The pivotal role of this dermatosis could massively improve endocrine and metabolic assessments.

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“…При синдроме поликистозных яичников (СПКЯ) формируется инсулинорезистентность, однако имеется ограниченное количество исследований о взаимосвязи развития СД2 в молодом возрасте и СПКЯ. У женщин в возрасте 18-45 лет, имеющих данный диагноз, увеличивается риск развития СД2 в молодом возрасте [13,14]. Олигоменорея в подростковом периоде повышала риск развития СД2 в молодом возрасте в 6,5 раза по сравнению с пациентками, у которых не было нарушения менструального цикла [13,15].…”

Section: этиология сахарного диабета 2-го типаunclassified

“…У женщин в возрасте 18-45 лет, имеющих данный диагноз, увеличивается риск развития СД2 в молодом возрасте [13,14]. Олигоменорея в подростковом периоде повышала риск развития СД2 в молодом возрасте в 6,5 раза по сравнению с пациентками, у которых не было нарушения менструального цикла [13,15].…”

Section: этиология сахарного диабета 2-го типаunclassified

Features of the course of type 2 diabetes mellitus in young people

Ovsyannikova

Zubareva

2022

Medicinskij sovet

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The increase in the prevalence of type 2 diabetes mellitus (T2DM) worldwide in young people determines the high relevance in studying the course of this disease. There are difficulties in awareness of this pathology in young people, both in specialists and in patients due to the fact that the long-term outcomes of T2DM in young people are poorly understood. This leads to late diagnosis of diabetes and longer exposure to hyperglycemia leads to high risks of microand macrovascular complications. Clinical symptoms of T2DM with a debut at a young age are different in patients, so this disease is not always diagnosed on time. T2DM in young people (18–45 years) has a more aggressive course, the decrease in the level of β-cells occurs faster than in patients with late-onset T2DM. The risk of developing complications in T2DM with onset at a young age is higher than in late-onset diabetes, mainly due to the longer duration of the disease. With a duration of T2DM in young people of 13.3 ± 1.8 years it was shown that the incidence of nephropathy, neuropathy and retinopathy was 54.8%, 32.4% and 13.7%, respectively. According to the literature, in patients with T2DM at a young age, life expectancy is reduced by 14 and 16 years in males and females, respectively. The course of T2DM is more aggressive in relation to young patients than to middle-aged and elderly patients. T2DM with a debut at a young age is a socially significant disease, due to a decrease in the quality of life, the development of diabetic complications and early disability of the working population.

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

Cited by 6 publications

References 58 publications

Structural Lesions on Kidney Biopsy in Youth-Onset and Adult-Onset Type 2 Diabetes

Structural Lesions on Kidney Biopsy in Youth-Onset and Adult-Onset Type 2 Diabetes

Acanthosis Nigricans: Pointer of Endocrine Entities

Features of the course of type 2 diabetes mellitus in young people

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