Abstract
OBJECTIVE:
Recent reports indicate an increasing prevalence of type 2 diabetes mellitus (TD2M) in children and adolescents around the world in all ethnicities, possibly due to increasing prevalence of obesity. Therefore, it is essential that clinicians are aware of the clinical features of T2DM in these age groups.
METHODS:
All published cases of T2DM in children and adolescents were evaluated and the different clinical presentations of T2DM in minorities and Caucasian described.
RESULTS:
Manifestation of T2DM is usually at mid-to-late puberty with few symptoms such as mild-polyuria or polydipsia. Most of the children and adolescents are extremely obese. The great majority of children and adolescents with T2DM have relatives with T2DM, and show other clinical features of the insulin resistance syndrome such as hypertension, dyslipidemia, polycystic ovarian syndrome (PCOS) or acanthosis nigricans. One-third of the minority children with T2DM and the majority of the Caucasian children with T2DM were detected by screening in the absence of symptoms.
CONCLUSIONS:
It is becoming increasingly clear that overweight children above the age of 10 y with (1) clinical signs of insulin resistance (acanthosis nigricans, dyslipidemia, hypertension, PCOS), or (2) relatives with T2DM, or (3) of particular ethnic populations (Asian, Indians, Africa-Americans, Hispanics), or (4) extremely obese children should be screened for T2DM.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
American Diabetes Association. Type 2 diabetes in children and adolescents. Diabetes Care 2000; 23: 381–389.
Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, Nathan D, Palmer J, Rizza R, Saudek C, Shaw J, Steffes M, Stern M, Tuomilehto J, Zimmet P . Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003; 26: 3160–3167.
Fagot-Campagna A, Pettitt DJ, Engelgau MM, Burrows NR, Geiss LS, Valdez R, Beckles GL, Saaddine J, Gregg EW, Williamson DF, Narayan KM . Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr 2000; 136: 664–672.
Drake AJ, Smith A, Betts PR, Crowne EC, Shield JPH . Type 2 diabetes in obese white children. Arch Dis Child 2002; 86: 207–208.
Reinehr T, Andler W, Kapellen T, Kiess W, Richter-Unruh A, Schönau E, Seewi O, Heinze E, Wabitsch M . Clinical characteristics of type 2 diabetes mellitus in overweight European Caucasian adolescents. Exp Clin Endocr Diab 2005; 113: 167–170.
Rami B, Schober E, Nachbauer E, Waldhör T . Type 2 diabetes mellitus is rare but not absent in children under 15 years of age in Austria. Eur J Pediatr 2003; 162: 850–852.
Wabitsch M, Hauner H, Hertrampf M, Muche R, Hay B, Mayer H, Kratzer W, Debatin KM, Heinze E . Type II diabetes mellitus and impaired glucose regulation in Caucasian children and adolescents with obesity living in Germany. Int J Obes Relat Metab Disord 2004; 28: 307–313.
Wiegand S, Maikowski U, Blankenstein O, Biebermann H, Tarnow P, Grüters A . Type 2 diabetes and impaired glucose tolerance in European children and adolescents with obesity—a problem that is no longer restricted to minority groups. Eur J Endocrinol 2004; 151: 199–206.
Ebbeling CA, Pawlak DB, Ludwig DS . Childhood obesity: public-health crisis, common sense cure. Lancet 2002; 360: 473–482.
Kiess W, Böttner A, Raile K, Kapellen T, Müller G, Galler A, Paschke R, Wabitsch M . Type 2 diabetes mellitus in children and adolescents: a review from a European perspective. Horm Res 2003; 59 (suppl 1): 77–84.
Hug C, Lodish HV . Visfatin: a new adipokine. Science 2005; 307: 366–367.
Reinehr T, Roth C, Menke T, Andler W . Adiponectin before and after weight loss in obese children. J Clin Endocrinol Metab 2004; 89: 3790–3794.
Arslanian SA . Type 2 diabetes in children: clinical aspects and risk factors. Horm Res 2002; 57 (suppl 1): 19–28.
Arslanian SA . Metabolic differences between Caucasian and African-American children and the relationship to type 2 diabetes mellitus. J Pediatr Endocrinol Metab 2002; 15 (Suppl 1): 509–517.
Sinha R, Fisch G, Teague B, Tamborlane WV, Banyas B, Allen K, Savoye M, Rieger V, Taksali S, Barbetta G, Sherwin RS, Caprio S . Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Eng J Med 2002; 346: 802–810.
Velho G, Froguel P . Genetic metabolic and clinical characteristics of maturity onset diabetes of the young. Eur J Endocrinol 1998; 138: 233–239.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR . Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405–412.
Reinehr T, Wabitsch M . Type 2 diabetes mellitus in children and adolescents. In: Ganz M (ed). Prevention of type 2 diabetes. John Wiley & Sons Ltd: New York; 2005. pp 21–40.
DCCT Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl J Med 1993; 329: 977–986.
Reinehr T, de Sousa G, Andler W . Longitudinal analyses of the relationships between overweight, insulin resistance, and cardiovascular risk factors in obese children. Obes Res 2005. in press.
Reinehr T, Kiess W, Kapellen T, Andler W . Insulin sensitivity among obese children and adolescents, according to degree of weight loss. Pediatrics 2004; 114: 1569–1573.
Reinehr T, Kiess W, Kapellen T, Andler W . Improvement of glucose homeostasis after weight loss in obese children: in Reply. Pediatrics 2005; 115: 1441–1442.
Schober E, Holl RW, Grabert M, Thon A, Rami B, Kapellen T, Seewi O, Reinehr T . Diabetes mellitus type 2 in childhood and adolescence in Germany and parts of Austria. An estimate based on a prospective large quality-control database. Eur J Pediatr 2005. in press.
Malecka-Tendera E, Erhardt E, Molnar D . Type 2 diabetes mellitus in European children and adolescents. Acta Paediatrica 2005; 94: 543–546.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Reinehr, T. Clinical presentation of type 2 diabetes mellitus in children and adolescents. Int J Obes 29 (Suppl 2), S105–S110 (2005). https://doi.org/10.1038/sj.ijo.0803065
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0803065
Keywords
This article is cited by
-
Diabetic ketoacidosis in an adult with beta-ketothiolase deficiency (BKD) involving a novel ACAT1 variant : first report of established diabetes in BKD and a review of the literature
Clinical Diabetes and Endocrinology (2024)
-
Isolated compounds from Dracaena angustifolia Roxb and acarbose synergistically/additively inhibit α-glucosidase and α-amylase: an in vitro study
BMC Complementary Medicine and Therapies (2022)
-
Type 2 diabetes in children and adolescents: distinct characteristics and evidence-based management
Endocrine (2022)
-
Clinical Pharmacokinetics and Pharmacodynamics of Antihyperglycemic Medications in Children and Adolescents with Type 2 Diabetes Mellitus
Clinical Pharmacokinetics (2017)
-
Typ-2-Diabetes trifft auch immer mehr Jugendliche
Pädiatrie (2015)