Krnic N, Sesa V, Mrzljak A, Berkovic MC. Are treatment options used for adult-onset type 2 diabetes mellitus (equally) available and effective for children and adolescents? World J Diabetes 2024; 15(4): 623-628 [PMID: 38680687 DOI: 10.4239/wjd.v15.i4.623]
Corresponding Author of This Article
Maja Cigrovski Berkovic, MD, PhD, Associate Professor, Department for Sport and Exercise Medicine, University of Zagreb Faculty of Kinesiology, No. 15 Horvacanski zavoj, Zagreb 10000, Croatia. maja.cigrovskiberkovic@gmail.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Apr 15, 2024; 15(4): 623-628 Published online Apr 15, 2024. doi: 10.4239/wjd.v15.i4.623
Are treatment options used for adult-onset type 2 diabetes mellitus (equally) available and effective for children and adolescents?
Nevena Krnic, Vibor Sesa, Anna Mrzljak, Maja Cigrovski Berkovic
Nevena Krnic, Clinics for Pediatrics, University Hospital Center Zagreb, Zagreb 10000, Croatia
Vibor Sesa, Anna Mrzljak, Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Anna Mrzljak, University of Zagreb School of Medicine, Zagreb 10000, Croatia
Maja Cigrovski Berkovic, Department for Sport and Exercise Medicine, University of Zagreb Faculty of Kinesiology, Zagreb 10000, Croatia
Author contributions: Krnic N was involved in conceptualization of the study; Cigrovski Berkovic M was responsible for data curation; Krnic N and Mrzljak A drafted the original version of the manuscript; Mrzljak A and Sesa V reviewed and edited the manuscript. All authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: All authors have no conflict of interest regarding this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maja Cigrovski Berkovic, MD, PhD, Associate Professor, Department for Sport and Exercise Medicine, University of Zagreb Faculty of Kinesiology, No. 15 Horvacanski zavoj, Zagreb 10000, Croatia. maja.cigrovskiberkovic@gmail.com
Received: December 28, 2023 Peer-review started: December 28, 2023 First decision: January 20, 2024 Revised: January 29, 2024 Accepted: March 6, 2024 Article in press: March 6, 2024 Published online: April 15, 2024
Abstract
Youth-onset type 2 diabetes mellitus (T2DM), influenced by an increase in obesity, is a rising problem worldwide. Pathophysiological mechanisms of this early-onset T2DM include both peripheral and hepatic insulin resistance, along with increased hepatic fasting glucose production accompanied by inadequate first and second-phase insulin secretion. Moreover, the incretin effect is reduced. The initial presentation of type 2 diabetes can be dramatic and symptoms may overlap with those of type 1 diabetes mellitus. Therefore, immediate therapy should address hyperglycemia and associated metabolic derangements irrespective of ultimate diabetes type, while further therapy adjustments are prone to patients’ phenotype. New agents with proven glycemic and beyond glycemia benefits, such as Glucagon-like polypeptide 1 receptor agonists and Sodium-glucose cotransporter-2 inhibitors, used in the adult population of T2DM patients, might become increasingly important in the treatment armamentarium. Moreover, metabolic surgery is an option for markedly obese (body mass index > 35 kg/m2) children and adolescents suffering from T2DM who have uncontrolled glycemia and/or serious comorbidities when lifestyle and pharmacologic interventions fail. In this mini-review, we will discuss the potential of treatment options considering new data available from randomized control trials, including individuals with adult-onset type diabetes mellitus.
Core Tip: Youth-onset type 2 diabetes mellitus (T2DM) is a growing health problem. The incidence of youth-onset T2DM is especially high in overweight/obese individuals, in some ethnic groups with higher preponderance in female sex. Due to more aggressive course of T2DM in youth and earlier development of chronic complications, the stricter metabolic control targeting both glycemia and other vascular risk factors might be necessary. Newer agents with cardiovascular benefits and weight losing potential might become increasingly important in treatment of youth-onset T2DM. Moreover, future studies should focus on different approaches according to gender and use of new technologies in glucose monitoring.
