title: Mitigating micro-and macro-vascular complications of diabetes beginning in adolescence.
abstract: Diabetes is a chronic disorder, which manifests when insulin levels or resistance to insulin action becomes insufficient to control systemic glucose levels. Although the number of available agents to manage diabetes continues to expand rapidly, the maintenance of euglycemia by individuals with diabetes remains a substantial challenge. Unfortunately, many patients with type 1 and type 2 diabetes will ultimately experience diabetes complications. These complications result from the toxic effects of chronic hyperglycemia combined with other metabolic derangements that afflict persons with diabetes. This review will present a comprehensive look at the complications of diabetes, the risk factors for their progression, the mechanistic basis for their development, and the clinical approach to screening for, preventing, and treating these sequelae. In addition, since diabetes is commonly diagnosed in childhood, we will provide a special focus on the care of the adolescent patient.
authors.affiliation: Department of Pediatrics, Division of Endocrinology and Diabetes, Vanderbilt Children's Hospital, Nashville, TN 37232-9170, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Moore
authors.forename: Justin M
authors.initials: JM
authors.lastname: Gregory
authors.forename: Yaa A
authors.initials: YA
authors.lastname: Kumah-Crystal
authors.forename: Jill H
authors.initials: JH
authors.lastname: Simmons
mesh_terms: D000293:Adolescent; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D018450:Disease Progression; D006801:Humans; D008403:Mass Screening; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors