Type 2 Diabetes in Childhood and Adolescence: A Global Perspective
http://www.100md.com
《新英格兰医药杂志》
As a consequence of the steep worldwide rise in obesity in children and adolescents, type 2 diabetes, once rarely seen in this age group, has emerged and is changing the face of pediatric diabetology. One dire prediction from the Centers for Disease Control and Prevention is that if the current rate of obesity continues, diabetes will eventually develop in one in three children who were born in 2000. Although relatively little is known about type 2 diabetes in youth, this book — the first of its kind about the topic — provides valuable information on the epidemiology, pathophysiology, genetics, and possible treatment of this relentless metabolic disease.
Type 2 Diabetes in Childhood and Adolescence is attractively produced, with excellent illustrations and references. Of particular note is the book's international scope. Indeed, the two chapters regarding the Asian experience with the disease are of particular interest. In young Japanese patients, the incidence of type 2 diabetes is higher than it is in young whites, and coeditor Kaichi Kida describes well the clinical phenotype of the Japanese child who presents with the disease. I also recommend the chapter entitled "Long-term Outcomes of Type 2 Diabetes in Adolescence," which provides an extensive and detailed analysis of the incidence of both retinopathy and nephropathy. Rather frightening are the data showing that type 2 diabetes is the chief cause of nephropathy among young people in Japan.
The drawing on the cover of the book illustrates the cascade of events that ultimately leads to type 2 diabetes, from insulin resistance (frequently as a consequence of obesity) to impaired glucose tolerance to greater insulin resistance and deficiency and, ultimately, to diabetes. However, only two chapters deal with the pathophysiology of the disease — perhaps a reflection of the lack of studies in this age group. One topic that the book does not address is the role of gestational diabetes in early-onset disease in children. Also, the book would have gained in comprehensiveness from devoting a chapter to the Pima Indians of Arizona, who reportedly have the highest prevalence of type 2 diabetes in the world.
Aside from these criticisms, this book is easy to read and is generally filled with useful and practical information. I recommend it to any pediatric diabetologist who desires a perspective on type 2 diabetes in youth.
Sonia Caprio, M.D.
Yale University School of Medicine
New Haven, CT 06520
sonia.caprio@yale.edu(Edited by Martin Silink, )
Type 2 Diabetes in Childhood and Adolescence is attractively produced, with excellent illustrations and references. Of particular note is the book's international scope. Indeed, the two chapters regarding the Asian experience with the disease are of particular interest. In young Japanese patients, the incidence of type 2 diabetes is higher than it is in young whites, and coeditor Kaichi Kida describes well the clinical phenotype of the Japanese child who presents with the disease. I also recommend the chapter entitled "Long-term Outcomes of Type 2 Diabetes in Adolescence," which provides an extensive and detailed analysis of the incidence of both retinopathy and nephropathy. Rather frightening are the data showing that type 2 diabetes is the chief cause of nephropathy among young people in Japan.
The drawing on the cover of the book illustrates the cascade of events that ultimately leads to type 2 diabetes, from insulin resistance (frequently as a consequence of obesity) to impaired glucose tolerance to greater insulin resistance and deficiency and, ultimately, to diabetes. However, only two chapters deal with the pathophysiology of the disease — perhaps a reflection of the lack of studies in this age group. One topic that the book does not address is the role of gestational diabetes in early-onset disease in children. Also, the book would have gained in comprehensiveness from devoting a chapter to the Pima Indians of Arizona, who reportedly have the highest prevalence of type 2 diabetes in the world.
Aside from these criticisms, this book is easy to read and is generally filled with useful and practical information. I recommend it to any pediatric diabetologist who desires a perspective on type 2 diabetes in youth.
Sonia Caprio, M.D.
Yale University School of Medicine
New Haven, CT 06520
sonia.caprio@yale.edu(Edited by Martin Silink, )