Nutrition Publication

Type 2 Diabetes

Editor(s): International Committee of Paediatricians. 63 / 1

Global Prevalence of Type 2 Diabetes in Children and its Health Implications Insulin Resistance in Type 2 Diabetes in Children Complications of Type 2 Diabetes Primary and Secondary Prevention and Treatment of Type 2 Diabetes in Children

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Editorial

Author(s): Editorial Committee

Global Prevalence of Type 2 Diabetes in Children and its Health Implications Insulin Resistance in Type 2 Diabetes in Children Complications of Type 2 Diabetes Primary and Secondary Prevention and Treatment of Type 2 Diabetes in Children

Global Prevalence of Type 2 Diabetes in Children and Its Health Implications

Author(s): Z. Laron

Type 2 diabetes mellitus is not a single entitybut a group of syndromes characterised by resistanceto insulin and hyperinsulinaemia [1].Its nomenclature and definition have undergonechanges in recent years from “adult onset diabetesmellitus” to NIDDM (non-insulin dependentdiabetes mellitus) and now to type 2 diabetesmellitus. Its differentiation from “glucoseintolerance” and “chemical diabetes” remainscontroversial.

Insulin Resistance in Type 2 Diabetes in Children

Author(s): C. Lévy-Marchal, P. Czernichow

Insulin resistance is manifested by a reducedperipheral effect of insulin. It results in decreasedperipheral glucose uptake and utilisationby muscle, liver and adipose tissue. Thiswas demonstrated elegantly by DeFronzo etal. in 1979. They used the clamp technique inhealthy subjects and in patients with type 2diabetes. Their finding are illustrated in figure1 [1]. Insulin resistance is extremely frequentin obesity and often plays a key role in the progressionfrom glucose into lerance to overt diabetes.Sustained high level of insulin secretionis hypothesised to lead to β-cell “exhaustion”.

Complications of Type 2 Diabetes

Author(s): T.G. Barrett

Until relatively recently, most paediatricianssaw diabetes mellitus in childhood as an isolatedpancreatic disease, rather than an obesi tyrelated issue, as almost all diabetes in childrenwas type 1, and it was rare for a child to be overweightat presentation. Over 95% of childhooddiabetes worldwide are still type 1, caused byautoimmune destruction of the insulin-producingislets in the pancreas. The principal abnormalityis insulin deficiency, requiring lifelonginsulin treatment.

Primary and Secondary Prevention and Treatment of Type 2 Diabetes in Children

Author(s): A.L. Rosenboom, J.H. Silverstein

Primary prevention or intervention is defined asthat which prevents or delays the developmentof a disease or condition in individuals or populationsidentified to be at high risk for the condition[1]. The global pandemic of childhood obesity,associated with complications of insulinresistance, including type 2 diabetes mellitus,places the prevention of obesity in the categoryof primary prevention [2-5]. Secon dary preventionor intervention is defined as the treatmentof individuals who have developed a diseaseto prevent or delay the development of complications[1].