抄録
Childhood obesity is a growing public health issue in Japan, Europe, and the United States. Additionally, cases of pediatric type 2 diabetes resulting from obesity continue to increase. Thus, diabetes is no longer considered as an adult disease. The annual incidence of pediatric type 2 diabetes is 2.62 people per 100,000 with 83.7% suffering
from obesity. In many cases of type 2 diabetes, the patient is obese owing to genetic and environmental factors. Type 2 diabetes develops with accumulation of visceral fat accompanied by increased insulin resistance and reduced insulin secretion. The age of onset peaks between 12 and 14 years, which corresponds with adolescence. This is a period during which the secretion of growth and sex hormones increases and insulin resistance becomes physiologically higher. It is necessary to control blood glucose levels early in such cases. If metabolic abnormalities, such as hyperglycemia persist, over time complications particular to diabetes, including retinopathy, nephropathy and neuropathy, occur. Additionally, the dyslipidemia that accompanies hyperglycemia promotes nonalcoholic
fatty liver disease and arteriosclerosis, which cause conditions such as cirrhosis of the liver, myocardial infarction, and stroke. Most patients with pediatric type 2 diabetes are obese. Hence, the basic treatment strategy is diet and exercise therapy. However, diet and exercise therapy alone only effect blood glucose control in approximately 60% of patients, with the remainder requiring pharmacotherapy.
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