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- What is the most common age of presentation of T2DM in young individuals?
Increased prevalence of childhood obesity as a result of sedentary lifestyle and
consumption of calorie-dense food predisposes for the early development of
diabetes. Approximately 90 % of young individuals with T2DM present
between 10 and 18 years of age. During puberty, gonadal steroids-mediated
GH–IGF1 surge and increase in adipose tissue mass result in worsening of
insulin resistance and consequent development of hyperglycemia in genetically
predisposed individuals.- An 18-year-old boy was incidentally detected to have diabetes. He was obese
(BMI-32 Kg/m^2 ) and had grade 4 acanthosis nigricans. His father has
T2DM. Biochemistry revealed fasting plasma glucose of 190 mg/dl, postpran-
dial glucose 220 mg/dl, and HbA1c 8.8 %. How to manage further?
The presence of features of insulin resistance (obesity and acanthosis nigri-
cans), family history of T2DM, incidental detection, and peripubertal onset of
the disease in the index case point to a diagnosis of T2DM in the young. HeabFig 12.3 (a) A patient of T1DM having bilateral ptosis, periorbital cellulitis, and black necrotic
patch over the nose due to rhino–orbital mucormycosis, (b) CT scan of the paranasal sinuses show-
ing isodense lesion in right ethmoid gallery and maxillary sinus (black arrow) in the same patient
12 Diabetes in the Young