Type 2 diabetes mellitus in adolescents

Type 2 diabetes mellitus, a significant cause of adult morbidity and mortal ity, is being diagnosed more frequently in children and adolescents. Geneti c predisposition and environmental factors are important determinants for t he expression of this disease. Blacks, Hispanic Americans, and Native Ameri cans are known to be at higher risk for type 2 diabetes mellitus as adults and there appears to be increased prevalence of the disease in adolescent m embers of these groups. Obesity, sedentary lifestyle, and high-fat diet are associated with type 2 diabetes mellitus. A combination of peripheral insu lin resistance and relative insulin deficiency results in chronic hyperglyc emia The onset of hyperglycemia is usually slow and symptoms such as polyur ia and polydipsia are often subtle and may go unrecognized by the patient. The treatment of children and adolescents with type 2 diabetes mellitus is an area of active study. Programs targeting diet modification and increased physical activity are being developed in hopes of delaying or preventing t he onset of disease. This paper examines risk factors for the development o f type 2 diabetes mellitus, reviews diagnostic criteria, and discusses newl y established screening criteria for type 2 diabetes mellitus in children a nd adolescents. Curr Opin Pediatr 2000 12:310-315 (C) 2000 Lippincott Willi ams & Wilkins, Inc.