##Youth Onset Type-2 Diabetes## In recent years, type-2 diabe | Golden pharma

##Youth Onset Type-2 Diabetes##

In recent years, type-2 diabetes has emerged as a pediatric disease.

5000 new cases of youth onset type-2 diabetes get recorded in the US alone each year

Risk factors
The risk factors include obesity, maternal history of DM or GDM during the child's gestation, family history of diabetes in first or second degree relative, race(Native American, African American, Latino, Asian American, Pacific Islander) and signs of insulin resistance or conditions associated with insulin resistance(acanthosis nigricans, hypertension, dyslipidemia, polycystic ovarian syndrome or small for gestational age birth weight)

Symptoms
Similar to adult type-2 diabetes, the classic symptoms of youth onset type-2 diabetes include frequent urination and excessive thirst. Symptoms specific to young people include unexplained weight loss, growth impairment and bed wetting

Diagnosis

-Consists of a diagnostic blood test followed by type distinguishing tests

-RBS greater than or equal to 200 mg/dl
FPG greater than or equal to 126mg/dl
HbA1c greater than or equal to 6.5 %
2hr plasma glucose during an OGTT greater than or equal to 200mg/dl

-Distinguishing between type 1 and type 2 diabetes is difficult in the pediatric population.
Although children with youth onset DM rarely present before puberty, diabetes type solely based on age at diagnosis should never be considered. Measurement of pancreatic autoantibodies(glutamic acid decarboxylase 65, tyrosine phosphatase-link insulinoma and beta cell specific zinc transporter) is recommended to confirm the diabetes type. Antibody positive youth present more like individuals with type 1 diabetes.

Management

-Exercise
-Consumption of nutrient dense, high quality foods instead of nutrient poor, calorie dense meals, especially sugar containing beverages
-Pharmacologic managent: Intiate drugs at diagnosis of youth onset type 2 diabetes. Intial treatment should include metformin and/or insulin alone or in combination based on the metabolic status of the patient
-Follow up is also mandatory

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