ESPE Yearbook of Paediatric Endocrinology

Preface: Globally, new incidences of type 2 diabetes (T2DM) in children and adolescents were estimated as 41 600 in 2021. The first report of a cohort of prepubertal children with T2DM confirms increased prevalence of severe obesity and insulin resistance. The spreading of T2DM worldwide and in young children is seriously alarming. Thirteen years, on average, after initial diagnoses of T2DM, incidence rates for hypertension, dyslipidemia, diabetic kidney disease and retinopathy were more than 50%. A call to remove the term prediabetes and to include current glycemic thresholds for prediabetes as diabetes may promote early lifestyle and medication interventions.

Of utmost importance for clinical care is the evidence that high BMI, hyperinsulinemia and other metabolic syndrome (MetS) markers are associated with childhood sexual, physical and psychological abuse. Serum ferritin level was identified as a laboratory marker associated with the MetS. Contributions of fructose to obesity, the MetS, non-alcoholic fatty liver disease (NAFLD), cardiovascular disease (CVD) and cancer were reviewed. A number of new drugs, such as glucagon-like peptide 1 receptor (GLP1R) agonist and SGLT2 inhibitors, were shown to improve liver function, and other new drugs showed promising results. New drugs were also developed to treat hypertriglyceridemia, A potent small molecule targeting HNF-1α may be a new therapeutic strategy, and a novel vaccine given every six months proved efficient in mice.