Type 2 diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels resulting from insulin resistance and insufficient insulin secretion. In recent years, there has been an alarming rise in the prevalence of youth-onset type 2 diabetes, particularly in low- and middle-income countries. According to the International Diabetes Federation, an estimated 1.1 million children and adolescents worldwide have type 2 diabetes, a number projected to increase by 40% by 2030. This trend is worrisome as type 2 diabetes in youth is associated with a higher risk of complications, including cardiovascular disease, kidney failure, blindness, and premature death.
To address the rising prevalence of youth-onset type 2 diabetes, researchers and public health experts have called for concerted efforts to identify and implement effective preventive strategies. A new study published in the journal Diabetes Care provides an overview of emerging research priorities in the field of youth-onset type 2 diabetes that can inform such strategies.
The study identifies four key research priorities:
- Systematic surveillance of the entire course of youth-onset type 2 diabetes
To effectively prevent and manage youth-onset type 2 diabetes, it is essential to have a comprehensive understanding of the disease’s natural history, from the initial stages of normoglycemia (normal blood glucose levels) to the development of dysglycemia (impaired glucose tolerance or impaired fasting glucose) and ultimately to the full-blown type 2 diabetes and its complications. The study suggests that systematic surveillance should be conducted across different populations and settings to gain insights into the patterns and determinants of the disease progression. This information can help identify high-risk individuals and inform preventive interventions.
- Improved understanding of youth-onset type 2 diabetes pathophysiology
Type 2 diabetes is a complex disorder with multifactorial etiology, involving both genetic and environmental factors. While the pathophysiology of type 2 diabetes in adults has been extensively studied, less is known about the disease in youth. The study highlights the need for research to improve our understanding of the pathophysiology of youth-onset type 2 diabetes, including the role of insulin resistance, beta-cell dysfunction, and inflammation. This knowledge can aid in identifying high-risk individuals, developing targeted interventions, and monitoring treatment outcomes.
- Holistic approach for identifying lifetime exposures and experiences
The study recommends adopting a holistic approach to identify the lifetime exposures and experiences that contribute to the risk of youth-onset type 2 diabetes. This includes multilevel analyses of upstream contextual risk factors such as socioeconomic status, education, and access to healthcare, as well as downstream family and individual-level characteristics that promote the risk of type 2 diabetes, such as lifestyle behaviors, psychosocial stress, and sleep. The study emphasizes the need to integrate these multiple factors to develop more effective and tailored preventive interventions.
- Development of multilevel strategies for type 2 diabetes prevention
Finally, the study highlights the importance of developing multilevel strategies for type 2 diabetes prevention that consider the complex interactions between different risk factors and health outcomes. Such strategies should be tailored to the specific needs of different populations and settings and be designed to address not only type 2 diabetes but also other cardiometabolic conditions that are on the rise among young people worldwide, such as obesity, hypertension, and dyslipidemia.
Overall, the study underscores the urgent need for a comprehensive and multidisciplinary approach to tackle the rising prevalence of youth-onset type 2 diabetes. This requires collaboration between researchers, public health experts, policymakers, and communities to develop and implement effective preventive strategies. The study’s research priorities provide a roadmap for future research in this critical area and can help guide efforts to improve the health and well-being of young people around the world.