|
Sign In to gain access to subscriptions and/or personal tools.
|
Review: Early-onset type 2 diabetes mellitus: a condition with elevated cardiovascular risk?
Soon H Song
Diabetes Centre, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK, soon_song{at}hotmail.com
The age of onset of type 2 diabetes mellitus is falling and this condition has become increasingly common among those aged under 30 years including children and adolescents. Early-onset type 2 diabetes has been reported in various countries from different ethnic and cultural backgrounds reflecting the effects of sedentary lifestyle as part of globalisation and industrialisation affecting all societies. The pathophysiological features of early-onset type 2 diabetes is similar to the later-onset cohort characterised by β-cell failure and obesity-induced insulin resistance but the decline in β-cell function appears to be more rapid. Early-onset type 2 diabetes may be a more aggressive disease phenotype to develop cardiovascular complications than later-onset cohort, reflected by more adverse cardiovascular risk profile and higher relative risk for myocardial infarction. Given the paucity of clinical trial evidence in this population, clinical judgement is required to initiate treatments to prevent cardiovascular complications guided by assessment of global cardiovascular risk. Future research strategies should include exploration of cardiovascular risk factors. its natural history, development of complications and outcome studies pertaining to the treatment of cardiovascular risk factors.
Key Words: cardiovascular risk • early-onset type 2 diabetes • epidemiology • future direction • management dilemma • pathophysiology.
References
- Diabetes Atlas, third edition. International Diabetes Federation Brussels 2006, pp332.
- American Diabetes Association: Type 2 diabetes in children and adolescents. Diabetes Care 2000;23:381-9.[Web of Science][Medline]
[Order article via Infotrieve]
- Kitagawa T., Owada M., Urakami T., Yamanchi K. Increased incidence of non-insulin dependent diabetes mellitus among Japanese school children correlates with an increased intake of animal protein and fat. Clin Pediatr 1998;37:111-16.[Abstract/Free Full Text]
- Ogawa Y., Uchigata Y., Otani T., Iwamoto Y. Proportion of diabetes type in early-onset diabetes in Japan. Diabetes Care 2007;30:e30.[Free Full Text]
- Lammi N., Taskinen O., Moltchanova E. et al. A high incidence of type 1 diabetes and an alarming increase in the incidence of type 2 diabetes among young adults in Finland between 1992 and 1996. Diabetologia 2007;50:1393-400.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Hillier TA, Pedula KL Characteristics of an adult population with newly diagnosed type 2 diabetes: The relation of obesity and age of onset. Diabetes Care 2001;24:1522-7.[Abstract/Free Full Text]
- Mokdad AH, Ford ES, Bowman BA et al. Diabetes trends in the US: 1990-98. Diabetes Care 2000;23:1278-83.[Abstract/Free Full Text]
- National Health and Nutrition Examination Survey NHANES data on the prevalence of overweight among children and adolescents: United States, 2003-2004 Centres for Disease Control and Prevention, National Centre for Health Statistics, Health E-Stats, Hyattsville, USA 2005.
- Franks PW, Hanson RL, Knowler WC et al. Childhood predictors of young-onset type 2 diabetes. Diabetes 2007;56:2964-72.[Abstract/Free Full Text]
- Dr Foster's case note. Obesity and type 2 diabetes in children, 1996-7 to 2003-4 BMJ 2005;331:1167.[Free Full Text]
- Lee JM, Okumura MJ, Freed GL, Menon RK, Davis MM Trends in hospitalisation for diabetes among children and young adults: United States 1993-2004. Diabetes Care 2007;30:1-5.[Free Full Text]
- Yokoyama H., Okudaira M., Otani T. et al. Existence of early onset NIDDM Japanese demonstrating severe diabetic complications. Diabetes Care 1997;20:844-7.[Abstract]
- Eppens MC, Craig ME, Cusumano J. et al. Prevalence of diabetic complications in adolescents with type 2 compared with type 1 diabetes. Diabetes Care 2006;29:1300-06.[Abstract/Free Full Text]
- Pinhas-Hamiel O., Zeitler P. Acute and chronic complications of type 2 diabetes mellitus in children and adolescents. Lancet 2007;369:1823-31.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Scott A., Toomath R., Bouchier D. et al. First national audit of the outcomes of care in young people with diabetes in New Zealand: high prevalence of nephropathy in Maori and Pacific Islanders. N Z Med J 2006;119:U2015.[Medline]
[Order article via Infotrieve]
- Pavkov ME, Bennet PH, Knowler WC et al. Effect of youth-onset type 2 diabetes mellitus on incidence of end-stage renal disease and mortality in young and middle-aged Pima Indians. JAMA 2006;296:421-6.[Abstract/Free Full Text]
- Pavkov ME, Bennet PH, Sievers ML et al. Predominant effect of kidney disease on mortality in Pima Indians with or without type 2 diabetes. Kidney Int 2005;68:1267-74.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Gungor N., Bacha F., Saad R., Janosky J., Arslanian S. Youth type 2 diabetes: insulin resistance, beta-cell failure or both? Diabetes Care 2005;28:638-44.[Abstract/Free Full Text]
- Gungor N., Arslanian S. Progressive beta cell failure in type 2 diabetes mellitus of youth. J Pediatr 2004;144:656-9.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Matthews DR, Cull CA, Stratton IM, Holman RR, Turner RC UKPDS 26: sulphonylurea failure in non-insulin dependent diabetic patients over six years. UK Prospective Diabetes Study Group. Diabet Med 1998;15:297-303.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Hillier TA, Pedula KL Complications in young adults with early-onset type 2 diabetes: losing the relative protection of youth. Diabetes Care 2003;26:2999-3005.[Abstract/Free Full Text]
- Vereecken CA, Inchley J., Subramanian SV, Hublet A., Maes L. The relative influence of individual and contextual socio-economic status on consumption of fruit and soft drinks among adolescents in Europe. Eur J Public Health 2005;15:224-32.[Abstract/Free Full Text]
- James J., Thomas P., Cavan D., Kerr D. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial. BMJ 2004;328:237.[Free Full Text]
- Schulze MB, Manson JE, Ludwig DS et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 2004;292:927-34.[Abstract/Free Full Text]
- Yoo S., Nicklas T., Baranowski T., Zakeri IF et al. Comparison of dietary intakes associated with metabolic syndrome risk factors in young adults: the Bogalusa Heart Study. Am J Clin Nutr 2004;80:841-8.[Abstract/Free Full Text]
- Elliott SS, Keim NL, Stern JS, Teff K., Havel PJ Fructose, weight gain, and the insulin resistance syndrome. Am J Clin Nutr 2002;76:911-22.[Abstract/Free Full Text]
- Frost G., Leeds AA, Dore CJ, Madeiros S., Brading S., Dornhorst A. Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet 1999;353:1045-8.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Willett W., Manson J., Liu S. Glycemic index, glycemic load, and risk of type 2 diabetes. Am J Clin Nutr 2002;76:274S-280S.[Abstract/Free Full Text]
- Hofmann SM, Dong HJ, Li Z. et al. Improved insulin sensitivity is associated with restricted intake of dietary glycoxidation products in the db/db mouse. Diabetes 2002;51:2082-9.[Abstract/Free Full Text]
- Vlassara H., Cai W., Crandall J. et al. Inflammatory mediators are induced by dietary glycotoxins, a major risk factor for diabetic angiopathy. Proc Natl Acad Sci U S A 2002;99:15596-601.[Abstract/Free Full Text]
- Pereira MA, Kartashov AI, Ebbeling CB et al. Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet 2005;365:36-42.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Rampersaud GC, Bailey LB, Kauwell GP National survey beverage consumption data for children and adolescents indicate the need to encourage a shift toward more nutritive beverages. J Am Diet Assoc 2003;3:97-100.
- Hu FB, Li TY, Colditz GA, Willett WC, Manson JE Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003;89:1785-91.
- Gungor N., Thompson T., Sutton-Tyrrell K., Janosky J., Arslanian S. Early signs of cardiovascular disease in youth with obesity and type 2 diabetes. Diabetes Care 2005;28:1219-21.[Free Full Text]
- Strong JP, Malcolm GT, McMahan CA et al. Prevalence and extent of atherosclerosis in adolescents and young adults: implications for prevention from the Pathological Determinants of Atherosclerosis in Youth Study. JAMA 1999;281:727-35.[Abstract/Free Full Text]
- Rodriguez BL, Fujimoto WY, Mayer-Davis EJ et al. Prevalence of cardiovascular risk factors in US children and adolescents with diabetes: the SEARCH for diabetes in youth study. Diabetes Care 2006;29:1891-6.[Abstract/Free Full Text]
- Song SH, Hardisty CA Cardiovascular risk profile of early and later onset type 2 diabetes. Practical Diabetes Int 2007;24:20-4.[CrossRef]
- Hatunic M., Burns N., Finucane F., Mannion C., Nolan JJ Contrasting clinical and cardiovascular risk status between early and later onset type 2 diabetes. Diabetes Vasc Dis Res 2005;2:73-5.[CrossRef]
- Burns N., Finucane FM, Hatunic M. et al. Early-onset type 2 diabetes in obese white subjects is characterised by a marked defect in beta cell insulin secretion, severe insulin resistance and a lack of response to aerobic exercise training. Diabetologia 2007;50:1500-08.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Hatunic M., Finucane FM, Burns N. et al. Vascular inflammatory markers in early-onset obese and type 2 diabetes subjects before and after three months' aerobic exercise training. Diabetes Vasc Dis Res 2007;4:231-4.
- O'Gorman DJ, Karlsson HK, McQuaid S. et al. Exercise training increases insulin-stimulated glucose disposal and GLUT-4 (SLC2A4) protein content in patients with type 2 diabetes. Diabetologia 2006;49:2983-92.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- British Cardiac Society, British Hypertension Society, Diabetes UK, Heart UK, Primary Care Cardiovascular Society, Stroke Society. Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005;91(suppl V):v1-v52.[Free Full Text]
- Kawahara R., Amemiya T., Yoshino M., Miyamae M., Sasamoto K., Omori Y. Dropout of young non-insulin-dependent diabetics from diabetic care. Diabetes Res Clin Pract 1994;24:181-5.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Dean H. NIDDM-Y in First Nation Children in Canada. Clin Pediatr (Phila) 1998;7:89-96.
- Confidential Enquiry into Maternal and Child Health (CEMACH). Pregnancy in Women with Type 1 and Type 2 Diabetes in 2002-2003, England, Wales and Northern Ireland. London: CEMACH 2005.
- Bennett PH An internist's perspective: Type 2 diabetes in childhood and adolescence: what does the future hold? Pediatric Diabetes 2007;8:352-3.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
The British Journal of Diabetes & Vascular Disease, Vol. 8, No. 2,
61-65 (2008)
DOI: 10.1177/14746514080080020201
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
D. C. Kaelber and F. Pickett
Simple Table to Identify Children and Adolescents Needing Further Evaluation of Blood Pressure
Pediatrics,
June 1, 2009;
123(6):
e972 - e974.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Purcell and C. Day
Achieving acceptable adiposity
The British Journal of Diabetes & Vascular Disease,
July 1, 2008;
8(4):
159 - 161.
[PDF]
|
|
|
|
|
|
|
J C. Agwu
Screening for type 2 diabetes mellitus in children and adolescents
The British Journal of Diabetes & Vascular Disease,
July 1, 2008;
8(4):
163 - 168.
[Abstract]
[PDF]
|
|
|
|
|
