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


RESULTS
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 beta-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.


CONCLUSIONS
Reverting obesity through lifestyle modification, that involves nutrition education, behavior modification and exercise, is an important step to prevent the progression to diabetes.
Cali
Anna Mg
AM
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Caprio
Sonia
S
D000293:Adolescent; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D003937:Diagnosis, Differential; D014943:Global Health; D006801:Humans; D008913:Minority Groups / Q000706:statistics & numerical data; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D011236:Prediabetic State / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence