Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Pediatric Drugs
Erschienen in: Pediatric Drugs 4/2002

01.04.2002 | Leading Article

Increasing Incidence of Type 2 Diabetes in Children and Adolescents

Treatment Considerations

verfasst von: Dr Arlan L. Rosenbloom

Erschienen in: Pediatric Drugs | Ausgabe 4/2002

Einloggen, um Zugang zu erhalten

Abstract

The emerging public health problem of type 2 diabetes in youth reflects increasing rates of childhood obesity. As in adults, type 2 diabetes in children is part of the insulin resistance syndrome that includes hypertension, dyslipidemia and other atherosclerosis risk factors, and hyperandrogenism seen as premature adrenarche and polycystic ovary syndrome. Studies in children document risk factors for type 2 diabetes and associated cardiovascular risk factors, including obesity, family history, diabetic gestation, and underweight or overweight for gestational age. Genetically determined insulin resistance, or limited β-cell reserve, has been demonstrated in high risk individuals. This genetic background, considered advantageous in a feast and famine existence (the thrifty genotype), is rendered detrimental with abundant food and physical inactivity, a lifestyle demonstrated to be typical of families of children with type 2 diabetes.
Case finding in high risk individuals who are asymptomatic may be an appropriate response to the public health challenge of type 2 diabetes in children, because risk factors for cardiovascular disease are already present at the time of diagnosis. Treatment is dictated by the degree of metabolic derangement and symptoms. The only data on the use of oral hypoglycemic agents in children has been with metformin. Prevention efforts will require community and government involvement to reduce obesity and increase physical activity in the child, as well as adult, population.
Literatur
1.
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2001; 24: S5–20CrossRef
2.
Rosenbloom AL, Kohrman A, Sperling M. Classification and diagnosis of diabetes mellitus in children and adolescents. J Pediatr 1981; 98: 320–3CrossRef
3.
Winter WE, Nakamura M, House DV. Monogenic diabetes mellitus in youth: the MODY syndromes. Endocrinol Metab Clin North Am 1999; 28: 765–85PubMedCrossRef
4.
Winter WE, Maclaren NK, Riley WJ, et al. Maturity onset diabetes of youth in black Americans. N Engl J Med 1987; 316: 285–91PubMedCrossRef
5.
Rosenbloom AL. Type 2 diabetes in children. American Association for Clinical Chemistry. Diagn Endocrinol Immunol Metab 2000; 18(5): 143–53
6.
Macaluso CJ, Bauer UE, Deeb LC, et al. Type 2 diabetes among Florida children, 1994 thourgh 1998. Public Health Reports. In press
7.
Pinhas-Hamiel O, Dolan LM, Zeitler PS. Diabetic ketoacidosis among obese African American adolescents with NIDDM. Diabetes Care 1997; 28: 484–6CrossRef
8.
American Diabetes Association. Type 2 diabetes in children and adolescents: consensus conference report. Diabetes Care 2000; 23: 381–9CrossRef
9.
Savage PJ, Bennett PH, Senter RG, et al. High prevalence of diabetes in young Pima Indians. Diabetes 1979; 28: 937–42PubMedCrossRef
10.
Dabelea D, Hanson RL, Bennett PH, et al. Increasing prevalence of type 2 diabetes in American Indian children. Diabetologia 1998; 41: 904–10PubMedCrossRef
11.
Dean HJ. NIDDM-Y in first nation children in Canada. Clin Pediatr (Phila) 1998; 39: 89–96CrossRef
12.
Fagot-Campagna A, Pettitt DJ, Engelgau MM, et al. Type 2 diabetes among North American children and adolescents: an epidemiological review and a public health perspective. J Pediatr 2000; 136: 664–72PubMedCrossRef
13.
Pinhas-Hamiel O, Dolan LM, Daniels SR, et al. Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatr 1996; 128: 608–15PubMedCrossRef
14.
Knowles HC. Diabetes mellitus in childhood and adolescence. Med Clin North Am 1971; 55: 975–87PubMed
15.
Pihoker C, Scott CR, Lensing SY, et al. Non-insulin dependent diabetes mellitus in African-American youths of Arkansas. Clin Pediatr (Phila) 1998; 37: 97–102CrossRef
16.
Neufeld ND, Raffal LF, Landon C, et al. Early presentation of type 2 diabetes in Mexican-American youth. Diabetes Care 1998; 21: 80–6PubMedCrossRef
17.
Kadiki OA, Reddy MR, Marzouk AA. Incidence of insulin-dependent diabetes (IDDM) and non-insulin-dependent diabetes (NIDDM) (0–34 years at onset) in Benghazi, Libya. Diabetes Res Clin Pract 1996; 32: 165–73PubMedCrossRef
18.
Chan JCN, Cheung CK, Swaminathan R, et al. Obesity, albuminuria, and hypertension among Hong Kong Chinese with non-insulin-dependent diabetes mellitus (NIDDM). Postgrad Med J 1993; 69: 204–10PubMedCrossRef
19.
Kitagawa T, Owada M, Urakami T, et al. Increased incidence of non-insulin dependent diabetes mellitus among Japanese school children correlates with an increased intake of animal protein and fat. Clin Pediatr (Phila) 1998; 37: 111–5CrossRef
20.
Sayeed MA, Hussain MZ, Banu A, et al. Prevalence of diabetes in a suburban population of Bangladesh. Diabetes Res Clin Pract 1997; 34: 149–55PubMedCrossRef
21.
Braun B, Zimmerman MB, Kretchmer N, et al. Risk factors for diabetes and cardiovascular disease in young Australian aborigines: a 5-year follow-up study. Diabetes Care 1996; 19: 472–9PubMedCrossRef
22.
McGrath NM, Parker GN, Dawson P. Early presentation of type 2 diabetes mellitus in young New Zealand Maori. Diabetes Res Clin Pract 1999; 43: 205–9PubMedCrossRef
23.
Ehtisham S, Barrett TG, Shawl NJ. Type 2 diabetes mellitus in UK children: an emerging problem. Diabet Med 2000; 17: 867–71PubMedCrossRef
24.
Lev-Ran A. Thrifty genotype: how applicable is it to obesity and type 2 diabetes? Diabet Rev 1999; 7: 1–22
25.
Lillioja S, Mott DM, Spraul M, et al. Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus: prospective studies of Pima Indians. N Engl J Med 1993; 329: 1988–92PubMedCrossRef
26.
Haffner SM, Stern MP, Dunn J, et al. Diminished insulin sensitivity and increased insulin response in non-obese, non-diabetic Mexican Americans. Metabolism 1990; 39: 842–7PubMedCrossRef
27.
Haffner SM, Miettinen H, Stern MP. Insulin secretion and resistance in non-diabetic Mexican Americans and non-Hispanic whites with a parental history of diabetes. J Clin Endocrinol Metab 1996; 81: 1846–51PubMedCrossRef
28.
Groop L, Forsblom C, Lehtovirta M, et al. Metabolic consequences of a family history of NIDDM (the Botnia Study): evidence for sex specific parental effects. Diabetes 1996; 45: 1585–93PubMedCrossRef
29.
Martin BC, Warram JH, Krolewski AS, et al. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet 1992; 340: 925–9PubMedCrossRef
30.
Pigon J, Giacca A, Ostenson C-G, et al. Normal hepatic insulin sensitivity in lean, mild non-insulin-dependent diabetic patients. J Clin Endocrinol Metab 1996; 81: 3702–8PubMedCrossRef
31.
O’Rahilly S, Turner RC, Matthew D. Impaired pulsatile secretion of insulin in relatives of patients with non-insulin-dependent diabetes. N Engl J Med 1988; 318: 1225–30PubMedCrossRef
32.
Phipps K, Barker DJP. Fetal growth and impaired glucose tolerance in men and women. Diabetologia 1993; 36: 225–8PubMedCrossRef
33.
Philips DIW, Barker DJP, Hales CN, et al. Thinness at birth and insulin resistance in adult life. Diabetologia 1994; 37: 150–4CrossRef
34.
Lithell HO, McKeigue PM, Gerglund L, et al. Relation at birth to non-insulin-dependent diabetes and insulin concentrations in men aged 50–60 years. BMJ 1996; 312: 406–10PubMedCrossRef
35.
Curhan GC, Willett WC, Rimm EB, et al. Birth weight and adult hypertension, diabetes mellitus, and obesity in US men. Circulation 1996; 94: 3246–50PubMedCrossRef
36.
Ravelli AC, van der Meulen JH, Michels RP, et al. Glucose tolerance in adults after prenatal exposure to famine. Lancet 1998; 351: 173–7PubMedCrossRef
37.
Levitt NS, Lambert EV, Woods D, et al. Impaired glucose tolerance and elevated blood pressure in low birth weight, non-obese, young South African adults: early programming of cortisol axis. J Clin Endocrinol Metab 2000; 85: 4611–8PubMedCrossRef
38.
Dabelea D, Pettitt DJ, Hanson RL, et al. Birthweight, type 2 diabetes, and insulin resistance in Pima Indian children and young adults. Diabetes Care 1999; 22: 944–50PubMedCrossRef
39.
Bavdekar A, Yajnik CS, Fall CHD, et al. Insulin resistance syndrome in 8-year-old Indian children: small at birth, big at 8 years, or both? Diabetes 1999; 48: 2422–9PubMedCrossRef
40.
Rosenbloom AL, Wheeler L, Bianchi R, et al. Age adjusted analysis of insulin responses during normal and abnormal oral glucose tolerance tests in children and adolescents. Diabetes 1975; 24: 820–8PubMedCrossRef
41.
Caprio S, Tamborlane WV. Metabolic impact of obesity in childhood. Endocrinol Metab Clin North Am 1999; 28: 731–47PubMedCrossRef
42.
Legro RS, Kunselman AR, Dodson WC, et al. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999; 84: 165–9PubMedCrossRef
43.
Lewy V, Danadian K, Arslanian SA. Early metabolic abnormalities in adolescents with polycystic ovarian syndrome (PCOS) [abstract]. Pediatr Res 1999; 45: 93ACrossRef
44.
Lewy V, Danadian K, Arslanian SA. Roles of insulin resistance & B-cell dysfunction in the pathogenesis of glucose intolerance in adolescents with polycystic ovary syndrome [abstract]. Diabetes 1999; 48: A292CrossRef
45.
Banerjee S, Raghavan S, Wasserman EJ, et al. Hormonal findings in African-American and Caribbean Hispanic girls with premature adrenarche: implications for polycystic ovarian syndrome. Pediatrics 1998; 102: E36PubMedCrossRef
46.
Vuguin P, Linder B, Rosenfeld RG, et al. The roles of insulin sensitivity, insulinlike growth factor I (IGF-I), and IGF-binding protein-1 and-3 in the hyperandrogenism of African American and Caribbean Hispanic girls with premature adrenarche. J Clin Endocrinol Metab 1999; 84: 2037–42PubMedCrossRef
47.
Ibañez L, Potau N, Marcos MV, et al. Exaggerated adrenarche and hyperinsulinism in adolescent girls born small for gestational age. J Clin Endocrinol Metab 1999; 84: 4739–41PubMedCrossRef
48.
Silverman BL, Metzger BE, Cho NH, et al. Impaired glucose tolerance in adolescent offspring of diabetic mothers: relationship to fetal hyperinsulinism. Diabetes Care 1995; 18: 611–7PubMedCrossRef
49.
Pettitt DJ, Aleck KA, Baird HR, et al. Congenital susceptibility to NIDDM: role of intrauterine environment. Diabetes 1988; 37: 622–8PubMedCrossRef
50.
Dabelea D, Knowler WC, Pettitt DJ. Effect of diabetes in pregnancy on offspring: follow-up research in the Pima Indians. J Matern Fetal Med 2000; 9: 83–8PubMedCrossRef
51.
Svec F, Nastasi K, Hilton C, et al. Black-white contrasts and insulin levels during pubertal development: the Bogalusa Heart Study. Diabetes 1992; 41: 313–7PubMedCrossRef
52.
Jiang X, Srinivasan SR, Radhakrishnamurthy B, et al. Racial (black-white) differences in insulin secretion and clearance in adolescents: the Bogalusa heart study. Pediatrics 1996; 97: 357–60PubMed
53.
Arslanian S. Insulin secretion and sensitivity in healthy African-American vs American-white children. Clin Pediatr (Phila) 1998; 37: 81–8CrossRef
54.
Danadian K, Lewy V, Janosky JJ, et al. Lipolysis in African-American children: is it a metabolic risk factor predisposing to obesity? J Clin Endocrinol Metab 2001; 86: 3022–6PubMedCrossRef
55.
Danadian K, Balasekaran G, Lewy V, et al. Insulin sensitivity in African-American children with and without a family history of type 2 diabetes. Diabetes Care 1999; 22: 1325–9PubMedCrossRef
56.
Ibañez L, Castell C, Tresserras R, et al. Increased prevalence of type 2 diabetes mellitus and impaired glucose tolerance in first-degree relatives of girls with a history of precocious pubarche. Clin Endocrinol (Oxf) 1999; 51: 395–401CrossRef
57.
Pinhas-Hamiel O, Standiford D, Hamiel D, et al. The type 2 family: a setting for development and treatment of adolescent type 2 diabetes mellitus. Arch Pediatr Adolesc Med 1999; 153: 1063–7PubMed
58.
Fletcher RH, Fletcher SW, Wagner EH. Clinical epidemiology, the essentials. 2nd ed. Baltimore (MD): Williams and Wilkins, 1988
59.
Sackett DL, Holland WW. Controversy in detection of disease. Lancet 1965; II: 357–9
60.
Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics 1998; 101: 497–504PubMed
61.
62.
Cook VV, Hurley JS. Prevention of type 2 diabetes in childhood. Clin Pediatr (Phila) 1998; 37: 123–9CrossRef
63.
Teufel NI, Ritenbaugh CK. Development of a primary prevention program: insight gained in the Zuni Diabetes Prevention Program. Clin Pediatr (Phila) 1998; 37: 131–41CrossRef
64.
Macaulay AC, Paradis G, Potvin L, et al. The Kahnawake Schools Diabetes Prevention project: intervention, evaluation and baseline results of a diabetes primary prevention program with a native community in Canada. Prev Med 1997; 26: 779–90PubMedCrossRef
65.
Perry CL, Stone EJ, Parcel GS, et al. School-based cardiovascular health promotion: the child and adolescent trial for cardiovascular health (CATCH). J Sch Health 1990; 60: 406–13PubMedCrossRef
66.
Joe JR. Perceptions of diabetes by Indian adolescents. In: Joe JR, Young RS, editors. Diabetes as a disease of civilization: the impact of culture change on indigenous peoples. Berlin: Mouton de Gruyter, 1994: 329–356CrossRef
67.
Silverstein JH, Rosenbloom AL. Treatment of type 2 diabetes in children and adolescents. J Pediatr Endocrinol Metab 2000; 13: 1403–9PubMed
68.
DeFronzo RA, Goodman AM. Efficacy of metformin in patients with non-insulin dependent diabetes mellitus. The Multicenter Metformin Study group. N Engl J Med 1995; 333: 541–9PubMedCrossRef
69.
Jones KL, Arslanian S, Peterokova VA, et al. Effect of metformin in pediatric patients with type 2 diabetes: a randomized controlled trial. Diabetes Care 2002; 25: 89–94PubMedCrossRef
70.
Lebovitz HE. Insulin secretagogues, old and new. Diabet Rev 1999; 7: 139–52
71.
Schwartz S, Raskin P, Fonseca V, et al. Effect of troglitazone in insulin-treated patients with type 2 diabetes. Troglitazone and Exogenous Insulin Study Group. N Engl J Med 1998; 338: 861–6PubMedCrossRef
72.
Chiasson J, Josse R, Hunt J, et al. The efficacy of acarbose in the treatment of patients with non-insulin-dependent diabetes mellitus: a multicenter controlled clinical trial. Ann Intern Med 1994; 121: 928–35PubMed
73.
UKPDS Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53CrossRef
74.
UKPDS Group. Tight blood pressure control and risk of macrovascular and micro-vascular complications in type 2 diabetes: UKPDS 38. BMJ 1998; 317: 703–13CrossRef
75.
Yokoyama H, Okudaira M, Otani T, et al. High incidence of diabetic nephropathy in early-onset Japanese NIDDM patients; risk analysis. Diabetes Care 1998; 21: 1080–5PubMedCrossRef
76.
Fagot-Campagna A, Knowler WC, Pettitt DJ. Type 2 diabetes in Pima Indian children: cardiovascular risk factors at diagnosis and 10 years later [abstract]. Diabetes 1998; Suppl. 1: A155
77.
Law RE, Goetze S, Xi XP, et al. Expression and function of PPARγ in rat and human vascular smooth muscle cells. Circulation 2000; 101: 1311–8PubMedCrossRef
Metadaten
Titel
Increasing Incidence of Type 2 Diabetes in Children and Adolescents
Treatment Considerations
verfasst von
Dr Arlan L. Rosenbloom
Publikationsdatum
01.04.2002
Verlag
Springer International Publishing
Erschienen in
Pediatric Drugs / Ausgabe 4/2002
Print ISSN: 1174-5878
Elektronische ISSN: 1179-2019
DOI
https://doi.org/10.2165/00128072-200204040-00001

Weitere Artikel der Ausgabe 4/2002

Pediatric Drugs 4/2002 Zur Ausgabe

Review Article

Treatment Options for Juvenile-Onset Systemic Lupus Erythematosus

Review Article

Ethical Issues in Including Pediatric Cancer Patients in Drug Development Trials

Review Article

Exercise-Induced Asthma in Children

Therapy In Practice

Management of Croup

Current Opinion

Should Pediatric Patients with Hyperlipidemia Receive Drug Therapy?

Neu im Fachgebiet Pädiatrie

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Erstmanifestation eines Diabetes-Typ-1 bei Kindern: Ein Notfall!

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Manifestiert sich ein Typ-1-Diabetes bei Kindern, ist das ein Notfall – ebenso wie eine diabetische Ketoazidose. Die Grundsäulen der Therapie bestehen aus Rehydratation, Insulin und Kaliumgabe. Insulin ist das Medikament der Wahl zur Behandlung der Ketoazidose.

Frühe Hypertonie erhöht späteres kardiovaskuläres Risiko

16.05.2024 Arterielle Hypertonie in der Pädiatrie Nachrichten

Wie wichtig es ist, pädiatrische Patienten auf Bluthochdruck zu screenen, zeigt eine kanadische Studie: Hypertone Druckwerte in Kindheit und Jugend steigern das Risiko für spätere kardiovaskuläre Komplikationen.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise