A practical evidence-based approach to management of type 2 diabetes in children and young people (CYP): UK consensus.

Publisher: BioMed Central Country of Publication: England NLM ID: 101190723 Publication Model: Electronic Cited Medium: Internet ISSN: 1741-7015 (Electronic) Linking ISSN: 17417015 NLM ISO Abbreviation: BMC Med Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2003-

Diabetes Mellitus, Type 2*/diagnosis ; Diabetes Mellitus, Type 2*/epidemiology ; Diabetes Mellitus, Type 2*/therapy ; Metformin*; Adult ; Humans ; Child ; Adolescent ; Comorbidity ; Obesity ; United Kingdom/epidemiology

Background: Type 2 diabetes in young people is an aggressive disease with a greater risk of complications leading to increased morbidity and mortality during the most productive years of life. Prevalence in the UK and globally is rising yet experience in managing this condition is limited. There are no consensus guidelines in the UK for the assessment and management of paediatric type 2 diabetes.
Methods: Multidisciplinary professionals from The Association of Children's Diabetes Clinicians (ACDC) and the National Type 2 Diabetes Working Group reviewed the evidence base and made recommendations using the Grading Of Recommendations, Assessment, Development and Evaluation (GRADE) methodology.
Results and Discussion: Young people with type 2 diabetes should be managed within a paediatric diabetes team with close working with adult diabetes specialists, primary care and other paediatric specialties. Diagnosis of diabetes type can be challenging with many overlapping features. Diabetes antibodies may be needed to aid diagnosis. Co-morbidities and complications are frequently present at diagnosis and should be managed holistically. Lifestyle change and metformin are the mainstay of early treatment, with some needing additional basal insulin. GLP1 agonists should be used as second-line agents once early ketosis and symptoms are controlled. Glycaemic control improves microvascular but not cardiovascular risk. Reduction in excess adiposity, smoking prevention, increased physical activity and reduction of hypertension and dyslipidaemia are essential to reduce major adverse cardiovascular events.
Conclusions: This evidence-based guideline aims to provide a practical approach in managing this condition in the UK.
(© 2024. The Author(s).)

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Keywords: Bariatric surgery; Children and young people; Complications of excess weight; Metformin; Physical activity; Type 2 diabetes

9100L32L2N (Metformin)

Date Created: 20240402 Date Completed: 20240403 Latest Revision: 20240404

20240404

PMC10986054

10.1186/s12916-024-03349-4

38561783