Comorbidities and complications of type 2 diabetes mellitus in children and adolescents
- Lori Laffel, MD, MPH
Lori Laffel, MD, MPH
- Professor of Pediatrics
- Harvard Medical School
- Britta Svoren, MD
Britta Svoren, MD
- Assistant Professor of Pediatrics
- University of Rochester Medical Center
Children and adolescents with type 2 diabetes mellitus (T2DM) are at increased risk for associated comorbidities including hypertension (with associated changes in cardiac structure), dyslipidemia, and nonalcoholic fatty liver disease.
Patients with T2DM, especially those with poor glycemic control, hypertension, and dyslipidemia, are also at risk for vascular complications. This has been best established in adults, but accumulating data suggest that it is also the case for children and adolescents with T2DM [1-3]. Glycemic control among adolescents with T2DM is often poor. Studies in several populations report that less than half of the adolescents with type 2 diabetes regularly attend follow-up visits . One study reported mean glycated hemoglobin concentrations of 12 percent, even among patients involved in active follow-up . Youth with T2DM have a higher risk for vascular complications, including diabetic kidney disease, retinopathy, and neuropathy, compared with those with type 1 diabetes, after adjustment for age, disease duration, glycemia, and obesity .
Diabetic ketoacidosis and hyperosmolar hyperglycemia are acute complications that sometimes develop in adolescent patients with T2DM [6-8]; these acute complications are discussed separately. (See "Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents".)
The comorbidities and complications of T2DM in children and adolescents are presented here. The epidemiology, presentation, diagnosis, and management of T2DM in children and adolescents are discussed separately. (See "Epidemiology, presentation, and diagnosis of type 2 diabetes mellitus in children and adolescents" and "Management of type 2 diabetes mellitus in children and adolescents".)
Children and adolescents with type 2 diabetes mellitus (T2DM) are at risk for comorbid conditions including hypertension, dyslipidemia, and nonalcoholic fatty liver disease (NAFLD). These disorders may be present before the diagnosis of T2DM and, like T2DM itself, are associated with excessive weight. (See "Epidemiology, presentation, and diagnosis of type 2 diabetes mellitus in children and adolescents".)
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- - Screening
- - Treatment
- - Screening
- - Treatment
- Nonalcoholic fatty liver disease (NAFLD)
- HYPERGLYCEMIA AND DKA
- VASCULAR COMPLICATIONS
- Microvascular complications
- - Retinopathy
- - Nephropathy
- - Neuropathy
- Macrovascular complications
- PSYCHOLOGICAL COMPLICATIONS
- OTHER COMPLICATIONS/COMORBIDITIES
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS
- Associated comorbidities
- - Hypertension
- - Dyslipidemia
- - Nonalcoholic fatty liver disease
- - Hyperglycemia
- - Vascular complications