Table 1 - uploaded by George Alberti
Content may be subject to copyright.
-Features to differentiate type 1 and 2 diabetes in young people Type 1 diabetes Type 2 diabetes 

-Features to differentiate type 1 and 2 diabetes in young people Type 1 diabetes Type 2 diabetes 

Source publication
Article
Full-text available
1. The aims of the consensus meeting were to review the epidemiology, pathophysiology, management, and implications of the rising prevalence of type 2 diabetes in young people and to suggest means by which the continuing rise in incidence and prevalence might be prevented. 2. The overall global prevalence of type 2 diabetes is rising steadily. Prev...

Context in source publication

Context 1
... -The appearance of type 2 diabetes in children and adoles- cents has exacerbated the existing issues in the classification of diabetes. There is now a problem in clinically distinguish- ing the etiology of diabetes in children and adolescents, often necessitating labo- ratory studies to differentiate type 1 from type 2 diabetes (Table 1). This requires tests that are not always available in the primary care environment or in many de- veloping countries. ...

Citations

... Elevated BMI accompanied by cardiometabolic risk factors, including insulin resistance, hypertension, and dyslipidemia, confers a tenfold greater risk of developing chronic diseases across the lifespan than those of normal weight [1]. Young adulthood is a life transition associated with weight gain and accumulation of cardiometabolic risk factors [2]. It is important to identify individuals who may be at risk for weight gain and cardiometabolic abnormalities in young adulthood and to identify effective preventive strategies. ...
Article
Full-text available
Young adulthood is often a period of substantial weight gain increasing risk for obesity and cardiometabolic disease. Uric acid (UA), a clinical marker of oxidative stress, is associated with cardiometabolic dysfunction in established CVD, type 2 diabetes, and CKD. Yet, few trials have examined UA as a predictor of cardiometabolic risk in young, healthy populations, particularly in the context of weight gain prevention intervention. The purpose of this ancillary study was to examine UA in the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized, controlled trial of weight gain prevention strategies in young healthy adults. UA was examined as a predictor of weight and cardiometabolic outcomes over 6 years; the impact of weight gain prevention interventions on UA was also examined. We found that higher baseline UA was a significant predictor of less favorable BMI, triglycerides, HDL, glucose, insulin, and HOMA, independent of age, sex, baseline weight, baseline level of the outcome variable, and weight gain prevention intervention. Additionally, ≥1% weight loss was associated with lower UA. UA is a promising biomarker for future weight gain and cardiometabolic risk in young adults that may respond to weight gain prevention. Clinical trial registration: clinicaltrials.gov identifier NCT01183689
... Diabetes mellitus is a serious threat to human lifespan worldwide, resulting in a 2-4 times increase in mortality compared with non-diabetic subjects (135,136). Cardiovascular complications are the leading cause of death from diabetes, accounting for 50-75% of deaths (137,138). It has been widely accepted that diabetes are prone to pro-thrombic condition by increasing coagulation activity, impaired fibrinolysis, endothelial dysfunction, and platelet hyper-reactivity. ...
Article
Full-text available
Non-communicable diseases (NCDs), represented by cardiovascular diseases and cancer, have been the leading cause of death globally. Improvements in mortality from cardiovascular (CV) diseases (decrease of 14%/100,000, United States) or cancers (increase 7.5%/100,000, United States) seem unsatisfactory during the past two decades, and so the search for innovative and accurate biomarkers of early diagnosis and prevention, and novel treatment strategies is a valuable clinical and economic endeavor. Both tumors and cardiovascular system are rich in angiological systems that maintain material exchange, signal transduction and distant regulation. This pattern determines that they are strongly influenced by circulating substances, such as glycolipid metabolism, inflammatory homeostasis and cyclic non-coding RNA and so forth. Platelets, a group of small anucleated cells, inherit many mature proteins, mRNAs, and non-coding RNAs from their parent megakaryocytes during gradual formation and manifest important roles in inflammation, angiogenesis, atherosclerosis, stroke, myocardial infarction, diabetes, cancer, and many other diseases apart from its classical function in hemostasis. MicroRNAs (miRNAs) are a class of non-coding RNAs containing ∼22 nucleotides that participate in many key cellular processes by pairing with mRNAs at partially complementary binding sites for post-transcriptional regulation of gene expression. Platelets contain fully functional miRNA processors in their microvesicles and are able to transport their miRNAs to neighboring cells and regulate their gene expression. Therefore, the importance of platelet-derived miRNAs for the human health is of increasing interest. Here, we will elaborate systematically the roles of platelet-derived miRNAs in cardiovascular disease and cancer in the hope of providing clinicians with new ideas for early diagnosis and therapeutic strategies.
... Prevention and early diagnosis remain the most impactful interventions to reduce the morbidity and mortality due to NCDs especially CVDs [20]. Few studies have evaluated the magnitude and T2D and CVD risk factors among the young adult population, with the conviction that they are at lower risk due to perceived active lifestyles [21,22]. Against such background, this study aimed to investigate the burden of T2D and CVD risk factors (hypertension, dyslipidemia, and abdominal obesity) among a young adult population in an urban setting of Mwanza; with the hypothesis that there is a high magnitude of unattended CVD risk factors with a foreseen danger in NCD morbidity and mortality. ...
Article
Introduction: traditionally, non-communicable diseases were diseases of public health concern in developed countries. Due to economic transition, they are becoming more prevalent in low and middle-income countries. Despite the trend, little has been done in the population of young adults of developing countries. This research aimed to explore the magnitude of type 2 diabetes mellitus, hypertension, dyslipidemia, and abdominal obesity among the young adult population in an urban setting of Tanzania. Methods: the current research used a cross-sectional community-based design, involving apparently healthy young adults aged 18 to 34 years, not known to have diabetes, hypertension, or dyslipidemia. Data on socio-demographic characteristics, medical history, anthropometry, blood pressure, and lipids were obtained per standard operating procedures and analyzed using STATA 13. Association between outcome variables (type 2 diabetes mellitus, hypertension, dyslipidemia, and abdominal obesity) and predictor variables (age, sex, education level, occupation, and economic status) were assessed by logistic regression. Results: 245 young adults with a median age of 21 (interquartile range [IQR]: 18-25) were recruited. Prevalence of diabetes mellitus and of impaired glucose tolerance (IGT) were 7.8% and 15.5% respectively. Abdominal obesity and dyslipidemia were present in 11.8% and 45.1% respectively. 34.3% had hypertension and the risk was significantly higher in males compared to females (OR 1.8, 95%CI 1.1, 3.1). The atherogenic coefficient was significantly associated with abdominal obesity; other atherogenic indices did not show significant associations with current disease conditions. Conclusion: alarmingly high prevalence of diabetes mellitus, impaired glucose tolerance, hypertension, abdominal obesity, and dyslipidemia were observed among young adults in Mwanza. This study highlights the need for concerted efforts for interventions targeting young adults in combating diabetes and cardiovascular disease (CVD) risk factors in Tanzania.
... The prevalence of type 2 diabetes (T2D) at all ages is rising worldwide, affecting health and quality of life. 1 The incidence of youth-onset T2D, first described in the 1990s, has increased significantly in the past decades. [2][3][4][5][6] This upsurge is believed to be linked to the growing pediatric obesity epidemic. 7,8 Although youth-onset T2D is observed globally, 9,10 incidence rates vary across continents, among racial and ethnic groups, and with socioeconomic position. ...
Article
Background: Prevalence of youth-onset type 2 diabetes (T2D) has increased worldwide, paralleling the rise in pediatric obesity. Occurrence and clinical manifestations vary regionally and demographically. Objectives: We assessed the incidence, and clinical and demographic manifestations of youth-onset T2D in Israel. Methods: In a national observational study, demographic, clinical, and laboratory data were collected from the medical records of children and adolescents, aged 10-18 years, diagnosed with T2D between the years 2008 and 2019. Results: The incidence of youth-onset T2D in Israel increased significantly from 0.63/100,000 in 2008 to 3.41/100,000 in 2019. The study cohort comprised 379 individuals [228 girls (59.7%), 221 Jews (58.3%), mean age 14.7±1.9 years]; 73.1% had a positive family history of T2D. Mean BMI z-score was 1.96 ± 0.7, higher in Jews than Arabs. High systolic (≥ 130 mmHg) and diastolic blood pressure (≥ 85 mmHg) were observed in 33.7% and 7.8% of patients, respectively; mean glycosylated hemoglobin (A1c) level at diagnosis was 8.8±2.5%. Dyslipidemia, with high triglyceride (>150 mg/dl) and low HDL-c (<40 mg/dl) levels, was found in 45.6% and 56.5%, respectively. Microalbuminuria and retinopathy were documented at diagnosis, 15.2% and 1.9%, respectively) and increased (36.7% and 4.6%, respectively) at follow-up of 2.9 ± 2.1 years. Criteria of metabolic syndrome were met by 224 (62.2%) patients, and fatty liver documented in 65%, mainly Jews. Psychosocial comorbidity was found in 31%. Treatment with metformin (45.6%), insulin (20.6%), and lifestyle modification (18%) improved glycemic control. Conclusions: Youth-onset T2D in Israel has increased significantly and presents a unique profile. This article is protected by copyright. All rights reserved.
... Widespread obesity and pronounced lifestyle changes have led to the emergence of diabetes mellitus as a global public health challenge in children and adolescents [1,2]. In the past, type 1 diabetes (T1D) was the predominant type among children, nonetheless, in the past 2 decades, type 2 diabetes mellitus (T2DM) has taken the lead [3,4]. However, in some populations, T1D remains the predominant type among pediatrics, even though T2DM is rising. ...
Article
Full-text available
This 12-month school-based intervention study investigated the effects of hybrid educational lifestyle modifications on glycemic control among Saudi youth with different glycemic statuses. A total of 2600 Arab adolescents aged 12–18 years were recruited from 60 randomly selected schools. Anthropometrics, blood glucose, and HbA1c were measured pre- and post-intervention. Participants were grouped according to baseline HbA1c into normal, prediabetes, and diabetes groups. All participants received lifestyle education at base line and at every 3-month interval to improve diet and exercise behavior. Diabetic and prediabetic participants received a tailored lifestyle intervention. Post-intervention, 643 participants were analyzed as follows: 20 participants from the diabetes group, 39 from prediabetes, and 584 from the normal group. A modest but significant improvement in the glycemic status of diabetic and prediabetic participants was observed, but not in the normal group. In the diabetes group, 11 (55%) participants achieved normal HbA1c levels, 5 had prediabetes levels, and only 4 remained within diabetes HbA1c levels. In the prediabetes group, 34 (87.2%) participants achieved normal HbA1c levels, while 2 (5.1%) participants remained prediabetic and 3 (7.7%) had diabetes HbA1c levels (p < 0.001). This hybrid lifestyle intervention program modestly reduces the risk of T2DM among youth with elevated HbA1c levels. The challenge of sustaining interest in adopting lifestyle changes for a longer duration should be addressed in further studies in this population.
... Furthermore, the associated health care costs for youth with DM are on average six times higher than for youth without DM [4]. While T1D is the most common in all children and young people, the incidence of T2D among teens is increasing significantly in teenagers [5]. Regardless of type, DM is a chronic condition with a requirement for lifelong management and can pose many challenges. ...
Article
Full-text available
Diabetes mellitus (DM) is a global public health issue. Type 1 diabetes (T1D) is the predominant diabetes type in children and always requires insulin therapy. The incidence rate of newly diagnosed T1D in children continues to increase in Ireland Roche et al. (Eur J Pediatr 175(12):1913-1919, 2016) and worldwide Patterson et al. (Diabetologia 62(3):408-417, 2019). The objective of this study was to conduct a literature review of the effects of various non-pharmacological therapeutic modalities on the control of diabetes in children. A literature review was performed using PubMed, Medline, Embase and Cochrane library to evaluate play, art, music and exercise therapy in the treatment of DM using the keywords: “paediatric”, “diabetes”, “play therapy”, “art therapy”, “music therapy” and “exercise therapy”. These search terms initially returned 270 cases, which resulted in a total of 11 papers being reviewed after eliminating duplicate or irrelevant papers. Literature review showed that all therapies have a positive impact on the child, but there is limited research looking at the impact of therapy on quantitative measures such as HbA1c or ‘time in range’.
... Another study in Benin also found FINDRISC to be useful in screening for T2D [11]. Despite these findings, no study has described its utility in screening for current diabetes mellitus and MetS among young adult populations in sub-Saharan African settings, whose risk has been increasing [15]. ...
... A total score was obtained by adding up scores for all parameters, and every participant had their FINDRISC scores recorded. Risk categories were categorized as per FINDRISC standard groups of low risk (<7), slightly elevated (7)(8)(9)(10)(11), moderate (12)(13)(14), high (15)(16)(17)(18)(19)(20), and very high risk (>20) [5,20]. ...
Article
Full-text available
Background: Simple and less costly screening tools are needed to combat the rising non-communicable diseases epidemic. This study aimed to evaluate the utility of The Finnish Diabetes Risk Score (FINDRISC) as a screening tool for prediabetes, T2D, and metabolic syndrome (MetS) in a population of young adults in urban Mwanza, Tanzania. Methods: A cross-sectional community-based study was conducted among participants aged 18–35 years. The FINDRISC questionnaire was used to collect data and compute the FINDRISC scores for each participant. Socio-demographic, anthropometric, blood glucose, and lipid profiles data were collected accordingly. Results: A total of 259 participants were recruited into the study. The median age was 21 years (IQR 19–27), and more than half 60.2% (156) were females. In total, 32.8% (85) of the participants had at least a slightly elevated risk of developing T2D in 10 years’ time. Compared to the Oral Glucose Tolerance Test (OGTT), FINDRISC had a sensitivity and specificity of 39.1% and 69.2%, respectively (aROC = 0.5). The FINDRISC score significantly correlated with MetS (p = 0.001). Conclusion: In this study, FINDRISC has shown low sensitivity and specificity in the screening of pre-diabetes/T2D. However, it has potential utility in the screening of MetS in a young-adult population.
... This was similar to the established evidence that nearly 80% of children with diabetes have a positive family history of diabetes. 16 In the present study, 19% of obese children had pre-diabetes. This was similar to the study results by Kaur et al who communicated a 18.2% prevalence of impaired glucose tolerance in obese children. ...
Article
Full-text available
Background: Obesity is a rising global epidemic in children which leads to pre-diabetes and overt diabetes. Identification at early stage helps in early intervention. This study was undertaken to study the prevalence of pre-diabetes in urban school going adolescents aged 11-17 years with high risk factors.Methods: This was a prospective cross-sectional study conducted in Chennai, India between December 2011 and November 2012. Overweight or obese adolescents in the age group 11-17 years, either with family history of diabetes or acanthosis nigricans or both were included. After obtaining informed consent from parents, history was obtained in pre-tested questionnaire.Results: 148 adolescents were enrolled in the study (n=148), 71.62% were females, mean weight was 59.54±10.44 kg, mean height was 150.92±8.62 cm, mean BMI was 26.19±3.23 and mean blood glucose was 82.1 mg/dl. 60.81% of subjects were overweight and others obese. Girls had statistically significant higher mean weight and mean BMI than boys. 78.37% had acanthosis nigricans, 47.29% had family history of diabetes, 12.16% had pre-diabetes and the mean blood glucose in pre-diabetics was 104.9 mg/dl. Pre-diabetes was higher in adolescents with family history of diabetes (p=0.038).Conclusions: Recognition of risk of type 2 diabetes in the asymptomatic pre-diabetes phase needs to be emphasized and targeted screening of high risk children for pre-diabetes seems to be justified. The morbidity and mortality of youth onset type 2 diabetes can be reduced only by early detection and treatment.
... The growing worldwide prevalence of T2DM in young people [10] has emphasized the need for identification and treatment of this condition in children and adolescents. T2DM has accounted for a significant number of adolescents with diabetes recently. ...
Article
Full-text available
Background: Despite the importance of and social concern regarding prevention of diabetes at younger ages, limited data are available. This study sought to analyze changes in the prevalence of type 2 diabetes mellitus (T2DM) in Koreans younger than 30 years according to sex, age, and level of income. Methods: The dataset analyzed in this study was derived from health insurance claims recorded in the National Health Insurance Service (NHIS) database. Participants' level of income was categorized as low (quintile 1, <20% of insurance premium) or others (quintile 2-5). Results: In males and females, the prevalence of T2DM per 10,000 people steadily increased from 2.57 in 2002 to 11.41 in 2016, and from 1.96 in 2002 to 8.63 in 2016. The prevalence of T2DM in girls was higher in the age group of 5 to 14 years. Even though the prevalence was higher among those older than 20 years, the increase had started earlier, in the early 2000s, in younger age group. Adolescents aged 10 to 19 years in low-income families showed a remarkable increase in prevalence of T2DM, especially in boys. Conclusion: The prevalence of T2DM in young Koreans increased more than 4.4-fold from 2002 to 2016, and the increase started in the early 2000s in younger age groups and in low-income families. This is the first study to examine the trend in prevalence of T2DM in children, adolescents, and young adults in Korea. Future studies and collaborations with social support systems to prevent T2DM at an early age group should be performed.
... There are two major types: type 1 diabetes (T1DM) and type 2 diabetes (T2DM), differentiated by the age of onset, degree of loss of β-cell function, degree of insulin resistance, presence of disease associated antibodies and requirement for insulin treatment (The American Diabetes Association 2020). Nevertheless, nowadays it is clear that none of these characteristics clearly discriminates between these types which are becoming more alike due to increased prevalence of obesity in children (Pulgaron and Delamater 2014), occurrence of T1DM in older population (Dhaliwal and Weinstock 2014) or T2DM at young age (Alberti et al. 2004). Furthermore, due to development of modern analytical techniques, genetic tests (Stein et al. 2014) and increasing knowledge on the pathophysiology, scientists and clinicians identified many additional subtypes of diabetes, even with the implications for the choice of treatment in some cases. ...
Article
Diabetes mellitus is a group of metabolic disorders characterized by the presence of hyperglycaemia. Due to its high prevalence and substantial heterogeneity, many studies have been investigating markers that could identify predisposition for the disease development, differentiate between the various subtypes, establish early diagnosis, predict complications or represent novel therapeutic targets. N-glycans, complex oligosaccharide molecules covalently linked to proteins, emerged as potential markers and functional effectors of various diabetes subtypes, appearing to have the capacity to meet these requirements. For instance, it has been shown that N-glycome changes in patients with type 2 diabetes and that N-glycans can even identify individuals with an increased risk for its development. Moreover, genome-wide association studies identified glycosyltransferase genes as candidate causal genes for both type 1 and type 2 diabetes. N-glycans have also been suggested to have a major role in preventing the impairment of glucose-stimulated insulin secretion by modulating cell surface expression of glucose transporters. In this chapter we aimed to describe four major diabetes subtypes: type 1, type 2, gestational and monogenic diabetes, giving an overview of suggested role for N-glycosylation in their development, diagnosis and management.