Type 2 diabetes in young people is an aggressive disease with a greater risk of complications leading to increased morbidity and mortality during the most productive years of life. Prevalence in the UK and globally is rising yet experience in managing this condition is limited. There are no consensus guidelines in the UK for the assessment and management of paediatric type 2 diabetes. Multidisciplinary professionals from The Association of Children’s Diabetes Clinicians (ACDC) and the National Type 2 Diabetes Working Group reviewed the evidence base and made recommendations using the Grading Of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Young people with type 2 diabetes should be managed within a paediatric diabetes team with close working with adult diabetes specialists, primary care and other paediatric specialties. Diagnosis of diabetes type can be challenging with many overlapping features. Diabetes antibodies may be needed to aid diagnosis. Co-morbidities and complications are frequently present at diagnosis and should be managed holistically. Lifestyle change and metformin are the mainstay of early treatment, with some needing additional basal insulin. GLP1 agonists should be used as second-line agents once early ketosis and symptoms are controlled. Glycaemic control improves microvascular but not cardiovascular risk. Reduction in excess adiposity, smoking prevention, increased physical activity and reduction of hypertension and dyslipidaemia are essential to reduce major adverse cardiovascular events. This evidence-based guideline aims to provide a practical approach in managing this condition in the UK.

中文翻译：

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儿童和青少年 2 型糖尿病管理的实用循证方法 (CYP)：英国共识

年轻人的 2 型糖尿病是一种侵袭性疾病，出现并发症的风险更大，导致生命中最富有成效的岁月的发病率和死亡率增加。英国和全球的患病率正在上升，但管理这种情况的经验有限。英国尚无儿童 2 型糖尿病评估和管理的共识指南。来自儿童糖尿病临床医生协会 (ACDC) 和国家 2 型糖尿病工作组的多学科专业人员审查了证据基础，并使用建议分级、评估、发展和评价 (GRADE) 方法提出了建议。患有 2 型糖尿病的年轻人应在儿科糖尿病团队中进行管理，并与成人糖尿病专家、初级保健和其他儿科专业人士密切合作。由于许多重叠的特征，糖尿病类型的诊断可能具有挑战性。可能需要糖尿病抗体来帮助诊断。诊断时经常出现合并症和并发症，应进行整体管理。改变生活方式和二甲双胍是早期治疗的主要手段，有些还需要额外的基础胰岛素。一旦早期酮症和症状得到控制，GLP1 激动剂应作为二线药物使用。血糖控制可以改善微血管，但不能改善心血管风险。减少过度肥胖、预防吸烟、增加体力活动以及减少高血压和血脂异常对于减少主要不良心血管事件至关重要。这一基于证据的指南旨在提供一种在英国管理这种情况的实用方法。