2.0.0.0 TYPE 2 DI­A­BETES

2.1.0.0 In­tro­duc­tion

For infor­mation on test­ing for type 2 di­a­betes and predi­a­betes in chil­dren and ado­les­cents, please refer to Sec­tion 2 “Clas­sification and Di­ag­no­sis of Di­a­betes.” For ad­di­tional sup­port for these rec­om­men­da­tions, see the ADA po­si­tion state­ment “Eval­u­a­tion and Man­age­ment of Youth-‍Onset Type 2 Di­a­betes” (2).

Type 2 di­a­betes in youth has in­creased over the past 20 years, and re­cent es­ti­mates sug­gest an in­ci­dence of ~5,000 new cases per year in the U.S. (119). The Cen­ters for Dis­ease Con­trol and Pre­ven­tion pub­lished pro­jec­tions for type 2 di­a­betes preva­lence using the SEARCH database; as­sum­ing a 2.3% an­nu­al in­crease, the preva­lence in those under 20 years of age will quadru­ple in 40 years (120,121).

Ev­i­dence sug­gests that type 2 di­a­betes in youth is dif­fer­ent not only from type 1 di­a­betes but also from type 2 di­a­betes in adults and has unique fea­tures, such as a more rapid­ly pro­gres­sive de­cline in β-cell func­tion and ac­cel­er­at­ed de­vel­op­ment of di­a­betes com­pli­ca­tions (2,122). Type 2 di­a­betes dis­pro­por­tion­ate­ly im­pacts youth of eth­nic and racial mi­nori­ties and can occur in com­plex psy­choso­cial and cul­tur­al en­vi­ron­ments, which may make it difficult to sus­tain healthy lifestyle changes and self-‍man­age­ment be­hav­iors (22,123–126). Ad­di­tion­al risk fac­tors as­so­ci­at­ed with type 2 di­a­betes in youth in­clude adi­pos­i­ty, fam­i­ly his­to­ry of di­a­betes, fe­male sex, and low so­cioe­co­nom­ic sta­tus (122).

As with type 1 di­a­betes, youth with type 2 di­a­betes spend much of the day in school. There­fore, close com­mu­ni­ca­tion with and the co­op­er­a­tion of school per­son­nel are es­sen­tial for op­ti­mal di­a­betes man­age­ment, safe­ty, and max­i­mal aca­dem­ic op­por­tu­ni­ties.