Insulin Dynamics and Pathophysiology in Youth-Onset Type 2 Diabetes

J Clin Endocrinol Metab. 2024 Sep 16;109(10):2411-2421. doi: 10.1210/clinem/dgae463.

Abstract

Youth-onset type 2 diabetes (T2D) is increasing around the globe. The mounting disease burden of youth-onset T2D portends substantial consequences for the health outcomes of young people and for health care systems. The pathophysiology of this condition is characterized by insulin resistance and initial insulin hypersecretion ± an inherent insulin secretory defect, with progressive loss of stimulated insulin secretion leading to pancreatic β-cell failure. Research studies focusing on youth-onset T2D have illuminated key differences for youth- vs adult-onset T2D, with youth having more profound insulin resistance and quicker progression to loss of sufficient insulin secretion to maintain euglycemia. There is a need for therapies that are targeted to improve both insulin resistance and, importantly, maintain sufficient insulin secretory function over the lifespan in youth-onset T2D.

Keywords: adolescent; beta cell dysfunction; hyperglycemia; insulin resistance; pediatric; prediabetes.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age of Onset
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / physiopathology
  • Humans
  • Insulin Resistance
  • Insulin Secretion
  • Insulin* / metabolism
  • Insulin-Secreting Cells / metabolism
  • Insulin-Secreting Cells / physiology

Substances

  • Insulin