TY - JOUR

T1 - Treatment of type 2 diabetes in children

T2 - what are the specific considerations?

AU - Grondahl, Magnus F. G.

AU - Johannesen, Jesper

AU - Kristensen, Kurt

AU - Knop, Filip K.

PY - 2021

Y1 - 2021

N2 - Introduction: The number of individuals under 18 years of age with type 2 diabetes is increasing at an alarming rate worldwide. These patients are often characterized by obesity and they often experience a more rapid disease progression than adults with type 2 diabetes. Thus, focus on prevention and management of complications and comorbidities is imperative. With emphasis on weight loss and optimal glycemic control, treatment includes lifestyle changes and pharmacotherapy, which in this patient group is limited to metformin, liraglutide and insulin. In selected cases, bariatric surgery is indicated. Areas covered: This perspective article provides an overview of the literature covering pathophysiology, diagnosis, characteristics and treatment of pediatric type 2 diabetes, and outlines the gaps in our knowledge where further research is needed. The paper draws on both mechanistic studies, large scale intervention trials, epidemiological studies and international consensus statements. Expert opinion: Type 2 diabetes in pediatric patients is an increasing health care problem, and the current treatment strategies do not successfully meet the many challenges and obstacles in this patient group. Treatments must be early, intensive, multifaceted and durable. Also, prevention of obesity and type 2 diabetes in at-risk children should be addressed and prioritized on all levels.

AB - Introduction: The number of individuals under 18 years of age with type 2 diabetes is increasing at an alarming rate worldwide. These patients are often characterized by obesity and they often experience a more rapid disease progression than adults with type 2 diabetes. Thus, focus on prevention and management of complications and comorbidities is imperative. With emphasis on weight loss and optimal glycemic control, treatment includes lifestyle changes and pharmacotherapy, which in this patient group is limited to metformin, liraglutide and insulin. In selected cases, bariatric surgery is indicated. Areas covered: This perspective article provides an overview of the literature covering pathophysiology, diagnosis, characteristics and treatment of pediatric type 2 diabetes, and outlines the gaps in our knowledge where further research is needed. The paper draws on both mechanistic studies, large scale intervention trials, epidemiological studies and international consensus statements. Expert opinion: Type 2 diabetes in pediatric patients is an increasing health care problem, and the current treatment strategies do not successfully meet the many challenges and obstacles in this patient group. Treatments must be early, intensive, multifaceted and durable. Also, prevention of obesity and type 2 diabetes in at-risk children should be addressed and prioritized on all levels.

KW - Adolescents

KW - children

KW - insulin

KW - liraglutide

KW - metformin

KW - obesity

KW - pediatric

KW - type 2 diabetes

KW - GLUCAGON-LIKE PEPTIDE-1

KW - GASTRIC BYPASS-SURGERY

KW - BETA-CELL FUNCTION

KW - CARDIOVASCULAR RISK-FACTORS

KW - BARIATRIC SURGERY

KW - WEIGHT-LOSS

KW - CLINICAL-TRIAL

KW - LIRAGLUTIDE PHARMACOKINETICS

KW - INSULIN-RESISTANCE

KW - PEDIATRIC-PATIENTS

U2 - 10.1080/14656566.2021.1954160

DO - 10.1080/14656566.2021.1954160

M3 - Journal article

C2 - 34420454

VL - 22

SP - 2127

EP - 2141

JO - Expert Opinion on Pharmacotherapy

JF - Expert Opinion on Pharmacotherapy

SN - 1465-6566

IS - 16

ER -