A growing body of research confirms what doctors have observed for years: youth-onset type 2 diabetes (T2D) is not simply an adult disease showing up early—it’s faster, more severe, and less responsive to standard treatments.
Dr. Kristen Nadeau of the University of Colorado School of Medicine, who’s treated pediatric T2D since the early 2000s, says kids diagnosed with this form of diabetes are developing life-threatening complications such as heart attacks and kidney failure as early as their 20s. “This is when they should be in their healthiest years,” she emphasized.
Published last month in Diabetes and Diabetes Care, a comprehensive review led by Nadeau and colleagues—including experts from CU Anschutz—marks a new phase in the study of youth-onset T2D. It highlights the upcoming DISCOVERY study, which will follow at-risk youth through puberty to understand the disease’s unique progression.
Key findings:
- Puberty is a key trigger. The insulin resistance caused by growth hormones during puberty, combined with obesity, appears to overstress the pancreas, accelerating disease onset.
- Early interventions fall short. Efforts like pre-diabetes treatment and early insulin use have not stopped pancreatic decline.
- High-risk groups include ethnic minorities. Youth from American Indian, Black, Hispanic, and Pacific Islander communities are disproportionately affected, likely due to both genetic and environmental factors.
- Fat distribution matters more than obesity alone. Kids who store fat in the liver and organs are at higher risk—even if not obese.
- Bariatric surgery shows promise. While not a scalable solution for all, it offers insights that could inform future drug development.
Though new GLP-1 medications are showing potential, experts like Nadeau warn that youth shouldn’t have to rely on surgery or lifelong medication. “We need to return to a society where this wasn’t the norm,” she said, calling for better access to healthy food, physical activity, and early preventive care.
“This is the first generation projected to live shorter lives than their parents. That should be a wake-up call for us all.”
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