Youth-Onset Type 2 Diabetes: What We’ve Learned From Key Youth-Onset Type 2 Diabetes Studies, What We Still Don’t Know, and Why It Is Important
Kristen J. Nadeau, Elizabeth J. Mayer‐Davis, Rose Gubitosi‐Klug, Philip Zeitler, Steven E. Kahn, Dana Dabelea, SEARCH, TODAY, RISE, and DISCOVERY study groups
Abstract
In this review, we describe the epidemiology, pathophysiology, pediatric-specific treatment response data, morbidity, and mortality of youth-onset type 2 diabetes. In recognition of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 75th anniversary, the focus is primarily on data from three landmark youth-onset type 2 diabetes studies funded by the NIDDK in the last 20+ years. We discuss the now-recognized aggressive clinical course of youth-onset type 2 diabetes, which only recently became appreciated as a pediatric disease among health care providers. We highlight the similarities and differences between youth-onset and adult-onset type 2 diabetes, in particular how type 2 diabetes in youth appears to have an accelerated clinical course with earlier onset of complications in comparison with adult-onset type 2 diabetes; how these findings influenced the care and treatment recommendations for youth with type 2 diabetes; and how the many lessons from these studies, in turn, highlight remaining unanswered questions. We feature recent findings regarding long-term follow-up of diabetes complications in these youth, and how they differ from youth with type 1 diabetes. Finally, we conclude with an overview of emerging studies and topics in type 2 diabetes research that have potential to inform effective preventive action strategies.