Type 2 diabetes in children and adolescents: distinct characteristics and evidence-based management.

PURPOSE: Since the dramatic rise of obesity prevalence in childhood and adolescence has contributed to increased rates of type 2 diabetes (T2D) in youth, we sought to explore current evidence-based management options for pediatric T2D patients. METHODS: A comprehensive literature search was performed for studies of T2D in childhood and adolescence until September 2021. RESULTS: Special pathophysiological and diagnostic characteristics of T2D in this age are presented, while the main focus of the article is on management. Lifestyle interventions with healthy diet and exercise are of great importance for the treatment of T2D in children and adolescents. Metformin and insulin remain the traditional therapeutical means, while liraglutide recently gained indication for children older than 10 years both in USA and Europe. Data on the use, efficacy, safety and therapeutic considerations of other pharmacological treatments in children and adolescents with T2D are critically discussed. CONCLUSION: Although many new and promising therapeutic strategies have been introduced during recent years for the management of T2D in adults, available therapeutic options for the management of pediatric T2D remain limited.

Prevalence of sleep-related symptoms in a primary care population - their relation to asthma and COPD.

AIMS: The aim of this study was to clarify the association between obstructive sleep apnoea/hypopnoea syndrome (OSAHS)-related symptoms and physician-diagnosed asthma and COPD. METHODS: 1501 subjects aged 19-90 years completed a structured questionnaire and underwent spirometry and respiratory physician assessment in 10 primary care centres. RESULTS: Frequent snoring was reported in 45.6%, breathing pauses during sleep in 11.0%, and excessive daytime sleepiness in 6.7% of the sample. COPD patients were more likely to report frequent snoring (OR=1.34; 95% CI:1.04-1.71), breathing pauses (OR=1.46; 95% CI:1.01-2.10), and excessive daytime sleepiness (OR=2.04; 95% CI:1.33-3.14). In contrast, there was no significant association between asthma patients and OSAHS-related symptoms. Gender differences were recognised as well. CONCLUSIONS: The increased likelihood for OSAHS-related symptoms in COPD patients, in contrast to patients with asthma, designates them as a target group for the screening of OSAHS in primary care.