CHEARS

Originally, type 2 diabetes was seen as a disorder of aging, with the symptoms well recognized in older adults. However, over the past two decades, there has been a rise in the frequency of type 2 diabetes in the younger generation. The negative impacts include a lifetime exposure to hyperglycemia and long-term complications, leading to poor quality of life. Moreover, the disease progression is more rapid as well as disruptive than in older patients, a factor that leads to early morbidity. New challenges have emerged for the healthcare system, which was hitherto equipped to focus on the more common type 1 diabetes in adolescents.

Key factors that drive the development of type 2 diabetes in young people

Early life factors

Research indicates that pre-disposition to early-onset type 2 diabetes might start at the womb, due to changes in the intrauterine environment, like exposure to hyperglycemia. Maternal undernutrition or over-nutrition are also associated with risks of obesity as well as type 2 diabetes. Studies have also shown a correlation to post-natal undernutrition.

Diet and obesity

Obesity is a global pandemic and its prevalence, accompanied by lifestyle changes, in children is a driving factor for type 2 diabetes in young people. Diet has changed for the worse, with increased consumption of carbonated and sugar-rich drinks as well as energy-dense food. It cannot be denied that these are major contributors to obesity. Increased adiposity is evident in the younger generation, and a primary cause is the regular intake of fast food. As a result, the body develops insulin resistance, high blood sugar as well as risks of cardiovascular diseases, all of which are the most common aspects of type 2 diabetes.

Physical activity

Naturally, low physical activity is a direct link to obesity. The definition of leisure activities has changed drastically in the young generation. Electronic gadgets do play a pivotal role in our lives, and that role must be duly acknowledged. However, it is equally important to keep in mind the health benefits of good physical activity. A balance must be maintained, and it is this balance that is being steadily disrupted. Children and adolescents are seriously deprived of vigorous physical activity in their growth years. There are studies that report that increased physical activity does in fact decrease the risk for insulin resistance.

Family history

More number of family members affected with type 2 diabetes means a younger age of onset, a common conclusion reached by several studies in different populations. This points towards a genetic predisposition to the risk of diabetes. Several mutations have been identified, and it is speculated that the genetic influence over type 2 diabetes could be more in the young population than the old.

PCOS (polycystic ovarian syndrome) in females

Young-onset type 2 diabetes is seen to be much more common in women and girls rather than men and boys. Polycystic ovarian syndrome, unfortunately, is quite common among adolescent girls and is associated with insulin resistance, leading to type 2 diabetes risk.

There are complications and comorbidities associated with young-onset type 2 diabetes because diabetes is a metabolic syndrome, characterized by a set of symptoms that often occur together. It is to be noted that these are much more severe than those found in adolescents with type 1 diabetes. Some of the complications are comorbidities are:

· Microvascular and cardiovascular disease

· High blood pressure

· Renal diseases

· Dyslipidemia

· Diabetic ketoacidosis

· Diabetic neuropathy

· Diabetic retinopathy

· Albuminuria

Management

Intensive lifestyle modification lies at the core of managing this disease. Weight control, increasing levels of physical activity, a healthy diet, restricted fast food, reduced sugar, and fat intake, and increased fiber consumption is some of the basic steps of management. This must include regular self-monitoring of blood glucose, as directed by the physician.

Professional care includes help not only from doctors but also from dieticians and psychologists.

It is a proven fact that glycemic control can be achieved through a healthy lifestyle.