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Treatment options and current guidelines of care for pediatric type 2 diabetes patients: a narrative review

Abstract Context Type 2 diabetes (T2D) mellitus, which was once considered a disease affecting adults, is a growing problem among youths. Research now shows that T2D in youths is more progressive and associated with earlier onset of complications than adult-onset T2D. Objectives To update practicing clinical physicians on what is currently known about pediatric T2D and share current guidelines to care for these patients. Methods The authors conducted a literature review through the MEDLINE/PubMed, Google Scholar, and clinicaltrials.gov databases in July 2019 using the following search phrases: “youth-onset type 2 diabetes,” “pediatric type 2 diabetes,” “diabetes in youth,” and “FDA-approved pediatric diabetes medications.” Items published between 2010 and 2019 and written in English were included. Results A total of 65 items were included after database review, including 44 articles, 10 FDA product inserts, six clinicaltrials.gov listings, three position statements/guideline documents, one website, and one FDA announcement. Conclusions There are very limited treatment options available to manage pediatric T2D. Prevention of pediatric T2D is paramount, which requires a high index of suspicion, routine screening of children and adolescents, and willingness to engage in family-based interventions for those at risk for prediabetes and T2D. Osteopathic physicians have a unique opportunity to help by applying the osteopathic principles to the whole person – including environmental, societal, and lifestyle factors – to help patients achieve their health and wellness goals.