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Prediabetes and type 2 diabetes in youth: an emerging epidemic disease?

Cali, Anna MG; Caprio, Sonia

Current Opinion in Endocrinology, Diabetes and Obesity: April 2008 - Volume 15 - Issue 2 - p 123–127
doi: 10.1097/MED.0b013e3282f57251
Diabetes and the endocrine pancreas: Edited by Allison B. Goldfine
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Purpose of review The prevalence of obesity in youth is increasing alarmingly among children and adolescents in the United States. The problem falls disproportionately on African-American and Hispanic children. Many of the metabolic and cardiovascular complications associated with obesity are already present during childhood and are closely linked to the concomitant insulin resistance/hyperinsulinemia and degree of obesity. Moreover, these co-morbidities persist into adulthood.

Recent findings The progression from normal glucose tolerance to type 2 diabetes mellitus involves an intermediate stage known as prediabetes or impaired glucose regulation. Prediabetes is characterized by peripheral insulin-resistance and impaired glucose sensitivity of first-phase insulin secretion. On the other hand, in overt type 2 diabetes mellitus β-cell failure becomes fully manifested. Progression from prediabetes to type 2 diabetes mellitus in youth is characterized by marked weight gain and further reduction in insulin secretion and insulin resistance.

Summary Reverting obesity through lifestyle modification, that involves nutrition education, behavior modification and exercise, is an important step to prevent the progression to diabetes.

Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA

Correspondence to Sonia Caprio, MD, Yale University School of Medicine, Department of Pediatrics, 330 Cedar St, P.O. Box 208064, New Haven, CT 06520, USA E-mail: Sonia.caprio@yale.edu

© 2008 Lippincott Williams & Wilkins, Inc.