Youth-onset type 2 diabetes: translating epidemiology into clinical trials

Pyle, Laura; Kelsey, Megan M.

doi:10.1007/s00125-021-05480-w

Cited by 12 publications

(8 citation statements)

References 63 publications

(80 reference statements)

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“…The initial clinical presentation is classically in the form of diabetic ketoacidosis with an acidic pH (<7.35), increased blood glucose and presence of plasmatic ketone bodies. However, it should be considered that the number of patients affected by T2D is increasing in the young population ( 19 ) making the diagnosis of T1D less obvious in young patients. Usually, the disease presents in 3 stages: The first stage consists in the destruction of beta cells with normal blood glucose levels and no symptoms.…”

Section: Methodsmentioning

confidence: 99%

Non-alcoholic fatty liver disease in type 1 diabetes: Prevalence and pathophysiology

Memaj

Jornayvaz

2022

Front. Endocrinol.

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Non-alcoholic fatty liver disease (NAFLD) is the most frequent chronic liver disease in the general population with a global prevalence of 25%. It is often associated with metabolic syndrome and type 2 diabetes, as insulin resistance and hyperinsulinemia are known to be favoring factors. Recent studies have described growing incidence of NAFLD in type 1 diabetes (T1D) as well. Although increasing prevalence of metabolic syndrome in these patients seems to explain part of this increase in NAFLD, other underlying mechanisms may participate in the emergence of NAFLD. Notably, some genetic factors are more associated with fatty liver disease, but their prevalence in T1D has not been evaluated. Moreover, oxidative stress, poor glucose control and long-lasting hyperglycemia, as well as exogenous insulin administration play an important role in intrahepatic fat homeostasis. The main differential diagnosis of NAFLD in T1D is glycogenic hepatopathy, which needs to be considered mostly in T1D patients with poor glycemic control. This article aims to review the prevalence and pathophysiology of NAFLD in T1D and open perspectives for clinicians taking care of T1D patients with potential hepatopathy.

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Section: Methodsmentioning

confidence: 99%

Non-alcoholic fatty liver disease in type 1 diabetes: Prevalence and pathophysiology

Memaj

Jornayvaz

2022

Front. Endocrinol.

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“…Failure to manage T1D for youth can lead to additional health complications thought their life including higher rates in emergency hospitalizations, episodes of diabetic ketoacidosis, and selfmanagement difficulties, all of which provide additional risk to youths' overall wellbeing (Cengiz et al, 2017). For example, diabetes distress, defined as "negative feelings that are specifically related to having and treating diabetes" (Pyle & Kelsey, 2021, p. 1713, is recognized as a comorbidity that can impact the management of diabetes long-term. Additionally, stressors of managing a chronic condition during times of self-identity and self-esteem building can impact a youth's self-image, shaping their attitudes towards diabetes management behaviors (Douma et al, 2018).…”

Section: T1d and Youthmentioning

confidence: 99%

Family Diabetes Camp Amidst COVID-19: A Community of Practice Model

Hill

Williams

Haegele

et al. 2022

JYD

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Studies have found that youth are experiencing higher anxiety levels than prior to COVID-19, and youth with type 1 diabetes are at higher risk. Medical specialty camps are a type of camp that provide opportunities for youth with chronic illnesses to share common goals, increase socialization, improve camper well-being, and increase knowledge of diabetes management. The program evaluation sought to determine the impact of a campers’ outcomes of independence and perceived competence and familial impact during COVID-19. Over half the participants were at their first diabetes camp and 71% of the campers felt their perceived competence “increased a little bit” because of camp. Over 95% of parents felt that their participation in camp had increased their diabetes knowledge. Qualitative data from parents revealed 2 themes, camp as a meeting place and learning from others. The findings from this study demonstrate that medical specialty camps influence campers’ perceptions of independence and competence and that families play an important role in creating a community of practice.

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“…As the prevalence has increased, there has also been a reduction in the average age at diagnosis, so that type 2 diabetes has become increasingly common in people in their teens, 20s, and 30s. [1][2][3] Type 2 diabetes in young people is of great concern; in what should be their most productive years those affected are at risk for the classical microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy) and for cardiovascular disease (CVD) associated with obesity-related metabolic syndrome. In high-income countries, type 2 diabetes in young people disproportionately affects marginalized indigenous and minority communities, a phenomenon related to high…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic status and risk factors for complications in young people with type 1 or type 2 diabetes: a cross-sectional study

Wijayaratna

Lee

Park

et al. 2021

BMJ Open Diab Res Care

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IntroductionYoung people with type 2 diabetes (T2D) develop complications earlier than those with type 1 diabetes (T1D) of comparable duration, but it is unclear why. This apparent difference in phenotype could relate to relative inequality.Research design and methodsCross-sectional study of young people referred to secondary diabetes services in Auckland, Aotearoa-New Zealand (NZ): 731 with T1D and 1350 with T2D currently aged <40 years, and diagnosed between 15 and 30 years. Outcome measures were risk factors for complications (glycemic control, urine albumin/creatinine ratio (ACR), cardiovascular disease (CVD) risk) in relation to a validated national index of deprivation (New Zealand Deprivation Index (NZDep)).ResultsYoung people with T2D were an average 3 years older than those with T1D but had a similar duration of diabetes. 71% of those with T2D were of Māori or Pasifika descent, compared with 24% with T1D (p<0.001). T1D cases were distributed evenly across NZDep categories. 78% of T2D cases were living in the lowest four NZDep categories (p<0.001). In both diabetes types, body mass index (BMI) increased progressively across the NZDep spectrum (p<0.002), as did mean glycated hemoglobin (HbA1c) (p<0.001), the prevalence of macroalbuminuria (p≤0.01), and CVD risk (p<0.001). Adjusting for BMI, diabetes type, and duration and age, multiple logistic regression revealed deprivation was the strongest risk factor for poorly controlled diabetes (defined as HbA1c >64 mmol/mol, >8%); OR 1.17, 95% CI 1.13 to 1.22, p<0.0001. Ordinal logistic regression showed each decile increase in NZDep increased the odds of a higher ACR by 11% (OR 1.11, 95% CI 1.06 to 1.16, p<0.001) following adjustment for BMI, blood pressure, diabetes type and duration, HbA1c, and smoking status. Multiple linear regression indicated a 4% increase in CVD risk for every decile increase in NZDep, regardless of diabetes type.ConclusionsThe apparent more aggressive phenotype of young-onset T2D is at least in part explicable by relative deprivation.

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Youth-onset type 2 diabetes: translating epidemiology into clinical trials

Cited by 12 publications

References 63 publications

Non-alcoholic fatty liver disease in type 1 diabetes: Prevalence and pathophysiology

Non-alcoholic fatty liver disease in type 1 diabetes: Prevalence and pathophysiology

Family Diabetes Camp Amidst COVID-19: A Community of Practice Model

Socioeconomic status and risk factors for complications in young people with type 1 or type 2 diabetes: a cross-sectional study

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