- 1. Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China;
Liu Juping,
Email: tydljp@126.com
The incidence of obesity and type 2 diabetes mellitus (T2DM) in adolescents has been rapidly increasing over the past two decades due to dramatic changes in dietary structure and physical activity. The incidence of diabetic retinopathy (DR), a serious vision-threatening complication of diabetes, is also increasing yearly in the adolescent population with T2DM. Due to the insidious onset of retinal diseases in the early stages, regular screening is important for the timely diagnosis of DR. However, there are still problems such as low attention of the population and insufficient screening rate. In the future, we should strengthen the health education of the adolescent population and optimize the control of risk factors such as blood glucose and blood pressure. At the same time, appropriate screening strategies should be actively developed, and the use of telemedicine and emerging technologies should be promoted for early detection of treatable lesions to improve patient prognosis.
| 1. | Jensen ET, Rigdon J, Rezaei KA, et al. Prevalence, progression, and modifiable risk factors for diabetic retinopathy in youth and young adults with youth-onset type 1 and type 2 diabetes: The SEARCH for Diabetes in Youth Study[J]. Diabetes Care, 2023, 46(6): 1252-1260. DOI: 10.2337/dc22-2503. |
| 2. | Mayer-Davis EJ, Lawrence JM, Dabelea D, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012[J]. N Engl J Med, 2017, 376(15): 1419-1429. DOI: 10.1056/NEJMoa1610187. |
| 3. | Divers J, Mayer-Davis EJ, Lawrence JM, et al. Trends in incidence of type 1 and type 2 diabetes among youths-selected counties and Indian reservations, United States, 2002-2015[J]. MMWR Morb Mortal Wkly Rep, 2020, 69(6): 161-165. DOI: 10.15585/mmwr.mm6906a3. |
| 4. | Tan GS, Cheung N, Simó R, et al. Diabetic macular oedema[J]. Lancet Diabetes Endocrinol, 2017, 5(2): 143-155. DOI: 10.1016/S2213-8587(16)30052-3. |
| 5. | Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus[J]. N Engl J Med, 1993, 329(14): 977-986. DOI: 10.1056/NEJM199309303291401. |
| 6. | TODAY Study Group. Development and progression of diabetic retinopathy in adolescents and young adults with type 2 diabetes: results from the TODAY Study[J]. Diabetes Care, 2021, 45(5): 1049-1055. DOI: 10.2337/dc21-1072. |
| 7. | Lascar N, Brown J, Pattison H, et al. Type 2 diabetes in adolescents and young adults[J]. Lancet Diabetes Endocrinol, 2018, 6(1): 69-80. DOI: 10.1016/S2213-8587(17)30186-9. |
| 8. | Shah AS, Nadeau KJ, Dabelea D, et al. Spectrum of phenotypes and causes of type 2 diabetes in children[J]. Annu Rev Med, 2022, 73: 501-515. DOI: 10.1146/annurev-med-042120-012033. |
| 9. | Perng W, Conway R, Mayer-Davis E, et al. Youth-onset type 2 diabetes: the epidemiology of an awakening epidemic[J]. Diabetes Care, 2023, 46(3): 490-499. DOI: 10.2337/dci22-0046. |
| 10. | Bjornstad P, Chao LC, Cree-Green M, et al. Youth-onset type 2 diabetes mellitus: an urgent challenge[J]. Nat Rev Nephrol, 2023, 19(3): 168-184. DOI: 10.1038/s41581-022-00645-1. |
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| 12. | American Diabetes Association. Type 2 diabetes in children and adolescents[J]. Diabetes Care, 2000, 23(3): 381-389. DOI: 10.2337/diacare.23.3.381. |
| 13. | Fu JF, Liang L, Gong CX, et al. Status and trends of diabetes in Chinese children: analysis of data from 14 medical centers[J]. World J Pediatr, 2013, 9(2): 127-134. DOI: 10.1007/s12519-013-0414-4. |
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| 15. | RISE Consortium, RISE Consortium Investigators. Effects of treatment of impaired glucose tolerance or recently diagnosed type 2 diabetes with metformin alone or in combination with insulin glargine on β-cell function: comparison of responses in youth and adults[J]. Diabetes, 2019, 68(8): 1670-1680. DOI: 10.2337/db19-0299. |
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| 17. | TODAY Study Group, Bjornstad P, Drews KL. Long-term complications in youth-onset type 2 diabetes[J]. N Engl J Med, 2021, 385(5): 416-426. DOI: 10.1056/NEJMoa2100165. |
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| 20. | Cho YH, Craig ME, Hing S, et al. Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006[J]. Pediatr Diabetes, 2011, 12(8): 682-689. DOI: 10.1111/j.1399-5448.2011.00762.x. |
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- 1. Jensen ET, Rigdon J, Rezaei KA, et al. Prevalence, progression, and modifiable risk factors for diabetic retinopathy in youth and young adults with youth-onset type 1 and type 2 diabetes: The SEARCH for Diabetes in Youth Study[J]. Diabetes Care, 2023, 46(6): 1252-1260. DOI: 10.2337/dc22-2503.
- 2. Mayer-Davis EJ, Lawrence JM, Dabelea D, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012[J]. N Engl J Med, 2017, 376(15): 1419-1429. DOI: 10.1056/NEJMoa1610187.
- 3. Divers J, Mayer-Davis EJ, Lawrence JM, et al. Trends in incidence of type 1 and type 2 diabetes among youths-selected counties and Indian reservations, United States, 2002-2015[J]. MMWR Morb Mortal Wkly Rep, 2020, 69(6): 161-165. DOI: 10.15585/mmwr.mm6906a3.
- 4. Tan GS, Cheung N, Simó R, et al. Diabetic macular oedema[J]. Lancet Diabetes Endocrinol, 2017, 5(2): 143-155. DOI: 10.1016/S2213-8587(16)30052-3.
- 5. Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus[J]. N Engl J Med, 1993, 329(14): 977-986. DOI: 10.1056/NEJM199309303291401.
- 6. TODAY Study Group. Development and progression of diabetic retinopathy in adolescents and young adults with type 2 diabetes: results from the TODAY Study[J]. Diabetes Care, 2021, 45(5): 1049-1055. DOI: 10.2337/dc21-1072.
- 7. Lascar N, Brown J, Pattison H, et al. Type 2 diabetes in adolescents and young adults[J]. Lancet Diabetes Endocrinol, 2018, 6(1): 69-80. DOI: 10.1016/S2213-8587(17)30186-9.
- 8. Shah AS, Nadeau KJ, Dabelea D, et al. Spectrum of phenotypes and causes of type 2 diabetes in children[J]. Annu Rev Med, 2022, 73: 501-515. DOI: 10.1146/annurev-med-042120-012033.
- 9. Perng W, Conway R, Mayer-Davis E, et al. Youth-onset type 2 diabetes: the epidemiology of an awakening epidemic[J]. Diabetes Care, 2023, 46(3): 490-499. DOI: 10.2337/dci22-0046.
- 10. Bjornstad P, Chao LC, Cree-Green M, et al. Youth-onset type 2 diabetes mellitus: an urgent challenge[J]. Nat Rev Nephrol, 2023, 19(3): 168-184. DOI: 10.1038/s41581-022-00645-1.
- 11. Lawrence JM, Divers J, Isom S, et al. Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017[J]. JAMA, 2021, 326(8): 717. DOI: 10.1001/jama.2021.11165.
- 12. American Diabetes Association. Type 2 diabetes in children and adolescents[J]. Diabetes Care, 2000, 23(3): 381-389. DOI: 10.2337/diacare.23.3.381.
- 13. Fu JF, Liang L, Gong CX, et al. Status and trends of diabetes in Chinese children: analysis of data from 14 medical centers[J]. World J Pediatr, 2013, 9(2): 127-134. DOI: 10.1007/s12519-013-0414-4.
- 14. Wu H, Patterson CC, Zhang X, et al. Worldwide estimates of incidence of type 2 diabetes in children and adolescents in 2021[J/OL]. Diabetes Res Clin Pract, 2022, 185: 109785[2022-02-18]. https://pubmed.ncbi.nlm.nih.gov/35189261/. DOI: 10.1016/j.diabres.2022.109785.
- 15. RISE Consortium, RISE Consortium Investigators. Effects of treatment of impaired glucose tolerance or recently diagnosed type 2 diabetes with metformin alone or in combination with insulin glargine on β-cell function: comparison of responses in youth and adults[J]. Diabetes, 2019, 68(8): 1670-1680. DOI: 10.2337/db19-0299.
- 16. Bacha F, El Ghormli L, Arslanian S, et al. Predictors of response to insulin therapy in youth with poorly-controlled type 2 diabetes in the TODAY trial[J]. Pediatr Diabetes, 2019, 20(7): 871-879. DOI: 10.1111/pedi.12906.
- 17. TODAY Study Group, Bjornstad P, Drews KL. Long-term complications in youth-onset type 2 diabetes[J]. N Engl J Med, 2021, 385(5): 416-426. DOI: 10.1056/NEJMoa2100165.
- 18. Dabelea D, Stafford JM, Mayer-Davis EJ, et al. Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood[J]. JAMA, 2017, 317(8): 825-835. DOI: 10.1001/jama.2017.0686.
- 19. White NH, Sun W, Cleary PA, et al. Effect of prior intensive therapy in type 1 diabetes on 10-year progression of retinopathy in the DCCT/EDIC: comparison of adults and adolescents[J]. Diabetes, 2010, 59(5): 1244-1253. DOI: 10.2337/db09-1216.
- 20. Cho YH, Craig ME, Hing S, et al. Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006[J]. Pediatr Diabetes, 2011, 12(8): 682-689. DOI: 10.1111/j.1399-5448.2011.00762.x.
- 21. Cioana M, Deng J, Nadarajah A, et al. Global prevalence of diabetic retinopathy in pediatric type 2 diabetes: a systematic review and meta-analysis[J/OL]. JAMA Netw Open, 2023, 6(3): e231887[2023-03-01]. https://pubmed.ncbi.nlm.nih.gov/36930156/. DOI: 10.1001/jamanetworkopen.2023.1887.
- 22. TODAY Study Group. Retinopathy in youth with type 2 diabetes participating in the TODAY clinical trial[J]. Diabetes Care, 2013, 36(6): 1772-1774. DOI: 10.2337/dc12-2387.
- 23. Ek AE, Samuelsson U, Janson A, et al. Microalbuminuria and retinopathy in adolescents and young adults with type 1 and type 2 diabetes[J]. Pediatr Diabetes, 2020, 21(7): 1310-1321. DOI: 10.1111/pedi.13074.
- 24. Unnikrishnan R, Anjana RM, Amutha A, et al. Younger-onset versus older-onset type 2 diabetes: clinical profile and complications[J]. J Diabetes Complications, 2017, 31(6): 971-975. DOI: 10.1016/j.jdiacomp.2017.03.007.
- 25. Zhang X, Saaddine JB, Chou CF, et al. Prevalence of diabetic retinopathy in the United States, 2005-2008[J]. JAMA, 2010, 304(6): 649-656. DOI: 10.1001/jama.2010.1111.
- 26. Lee JH, Kim YA, Lee Y, et al. Association between interarm blood pressure differences and diabetic retinopathy in patients with type 2 diabetes[J/OL]. Diab Vasc Dis Res, 2020, 17(7): 1479164120945910[2020-08-03]. https://pubmed.ncbi.nlm.nih.gov/32746630/. DOI: 10.1177/1479164120945910.
- 27. The Diabetes Control and Complications Trial Research Group. The relationship of glycemic exposure(HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial[J]. Diabetes, 1995, 44(8): 968-983. DOI: 10.2337/diab.44.8.968.
- 28. Ferm ML, DeSalvo DJ, Prichett LM, et al. Clinical and demographic factors associated with diabetic retinopathy among young patients with diabetes[J/OL]. JAMA Netw Open, 2021, 4(9): e2126126[2021-09-01]. https://pubmed.ncbi.nlm.nih.gov/34570208/. DOI: 10.1001/jamanetworkopen.2021.26126.
- 29. Chew EY. Screening for diabetic retinopathy in youth-onset diabetes[J]. Ophthalmology, 2017, 124(4): 422-423. DOI: 10.1016/j.ophtha.2017.02.001.
- 30. Porter M, Channa R, Wagner J, et al. Prevalence of diabetic retinopathy in children and adolescents at an urban tertiary eye care center[J]. Pediatr Diabetes, 2020, 21(5): 856-862. DOI: 10.1111/pedi.13037.
- 31. Wang SY, Andrews CA, Herman WH, et al. Incidence and risk factors for developing diabetic retinopathy among youths with type 1 or type 2 diabetes throughout the United States[J]. Ophthalmology, 2017, 124(4): 424-430. DOI: 10.1016/j.ophtha.2016.10.031.
- 32. Downie E, Craig ME, Hing S, et al. Continued reduction in the prevalence of retinopathy in adolescents with type 1 diabetes: role of insulin therapy and glycemic control[J]. Diabetes Care, 2011, 34(11): 2368-2373. DOI: 10.2337/dc11-0102.
- 33. Tao X, Li J, Zhu X, et al. Association between socioeconomic status and metabolic control and diabetes complications: a cross-sectional nationwide study in Chinese adults with type 2 diabetes mellitus[J]. Cardiovasc Diabetol, 2016, 15: 61. DOI: 10.1186/s12933-016-0376-7.
- 34. Benitez-Aguirre P, Craig ME, Cass HG, et al. Sex differences in retinal microvasculature through puberty in type 1 diabetes: are girls at greater risk of diabetic microvascular complications[J]. Invest Ophthalmol Vis Sci, 2014, 56(1): 571-577. DOI: 10.1167/iovs.14-15147.
- 35. Harjutsalo V, Maric C, Forsblom C, et al. Sex-related differences in the long-term risk of microvascular complications by age at onset of type 1 diabetes[J]. Diabetologia, 2011, 54(8): 1992-1999. DOI: 10.1007/s00125-011-2144-2.
- 36. Al-Saeed AH, Constantino MI, Molyneaux L, et al. An inverse relationship between age of type 2 diabetes onset and complication risk and mortality: the impact of youth-onset type 2 diabetes[J]. Diabetes Care, 2016, 39(5): 823-829. DOI: 10.2337/dc15-0991.
- 37. Levitsky LL, Drews KL, Haymond M, et al. The obesity paradox: retinopathy, obesity, and circulating risk markers in youth with type 2 diabetes in the TODAY Study[J/OL]. J Diabetes Complications, 2022, 36(11): 108259[2022-07-09]. https://pubmed.ncbi.nlm.nih.gov/36150365/. DOI: 10.1016/j.jdiacomp.2022.108259.
- 38. Zhou Y, Zhang Y, Shi K, et al. Body mass index and risk of diabetic retinopathy: a meta-analysis and systematic review[J/OL]. Medicine(Baltimore), 2017, 96(22): e6754[2017-06-02]. https://pubmed.ncbi.nlm.nih.gov/28562529/. DOI: 10.1097/MD.0000000000006754.
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