Evidence-Based on Type 2 Diabetes Mellitus in Children and Adolescents

The increasing onset of diabetes in young children is a matter of great concern. Twenty years ago, paediatric diabetes was almost exclusively type 1 diabetes mellitus (T1DM). Since then, rapid changes in the lifestyle of the Taiwanese people have resulted in parallel increases in obesity and the prevalence of type 2 diabetes mellitus (T2DM) in children. The alarming increase in the incidence of obesity in children and adolescents worldwide determined the increased risk for the occurrence of comorbidities, its injury being cardiovascular disease, type 2 diabetes mellitus (T2DM), metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), osteoarthritis, obstructive sleepapnea (OSA), some forms of cancer. Type 2 diabetes mellitus is a complex, chronic metabolic disease, presents a heterogeneous etiology, with risk factors at the social level and behavioral, environmental, and genetic susceptibility. It is associated with serious complications, but the early diagnosis and initiation of therapy may prevent or delay the onset of long-term complications. In children and adolescents, it was observed in particular increasing the prevalence of T2DM along with obesity, which is associated with insulin resistance. Patient and family education for a young person with T2DM is very important and will focus on behavioral changes (diet and activity). Given the need for aggressive and protective therapies early in the course of T2D, the study of adherence to treatment in adolescents with T2D is especially important. Treatment of T2D requires that adolescents make multiple behavior changes, including eating and physical activity, taking medications, and monitoring blood glucose. To date, most research on treatment adherence among youth with T2D has focused on identifying barriers to adherence. Multilevel barriers to T2D adherence are in line with SEM, including physiologic, individual, family, socioeconomic, health care systems, and cultural factors. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T2D.