REVIEW  UPDATE IN PEDIATRIC DIABETES AND ENDOCRINOLOGY: PROCEEDING OF THE 7TH WINTER AND SUMMER ISPED SCHOOL FOR PHYSICIANS 

Minerva Pediatrics 2021 December;73(6):549-62

DOI: 10.23736/S2724-5276.21.06530-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Type 2 diabetes in pediatrics

Elena FORNARI ¹, Fabrizio BARBETTI ², Dario IAFUSCO ³, Fortunato LOMBARDO ⁴, Emanuele MIRAGLIA DAL GIUDICE ⁵, Ivana RABBONE ⁶, Enza MOZZILLO ⁷ ✉

¹ Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics and Gynecology, University Hospital of Verona, Verona, Italy; ² Department of Experimental Medicine, Tor Vergata University, Rome, Italy; ³ Department of Pediatrics, Luigi Vanvitelli University of Campania, Naples, Italy; ⁴ Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy; ⁵ Department of the Woman, of the Child, of General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy; ⁶ Division of Pediatrics, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy; ⁷ Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, University of Naples Federico II, Naples, Italy

INTRODUCTION: Type 2 diabetes (T2D) in adolescents has become an increasing health concern throughout the world and its prevention and screening should be implemented in pediatric care. As clinical features at presentation, in some cases can be similar to type 1 diabetes and family history can be in favor of a monogenic form of diabetes, it is pivotal for physicians to be aware of youth-onset T2D specificities to ensure an accurate diagnosis.
EVIDENCE ACQUISITION: We conducted the first search in Medline, Embase, Web of Science, using different keywords and their compositions. The keywords used, also called “mesh” (MEdical Subject Headings) on PubMed, are the following: “type 2 diabetes” AND (“child*” OR “pediatr*” OR “adolesce*”) AND (“epidem*” OR “diagnos*” OR “treat*” OR “complication” OR “comorbidit*”). International review, systematic reviews and meta-analyses, randomized control trials and case reports published between May 2018 and February 2021 were considered, to identify publications that deal with the topic. No restrictions were applied regarding the published paper’s language.
EVIDENCE SYNTHESIS: The global increase of overweight and obesity can complicate the diagnostic process and makes it essential to apply a systematic approach to each new diagnosis. Microvascular complications may be present at the time of diagnosis and chronic complications are frequent and need to be screened regularly. Regular screening of comorbidities should also be performed. Childhood T2D should be followed up by pediatric diabetes units to avoid diagnostic errors and delay in care.
CONCLUSIONS: A multidisciplinary approach, by an experienced team, is pivotal to provide treatment options targeting the unique needs of pediatric patients. Treatment programs must include the whole family and address all the aspects of the care (lifestyle, pharmacological therapy, psychological aspects, complications and comorbidities). An organized process of transition to adult care is essential.

KEY WORDS: Diabetes Mellitus, Type 2; Pediatrics; Child; Adolescent; Epidemiology; Prevention and control