There has been wide recognition in the past decade of the increasing frequency of type 2 diabetes in youth,largely but not exclusively in North America.In s ome American locations and populations,incidence and prevalence of type 2 diabe tes are much higher than those of type 1 diabetes,because of increased calorie and fat intake,and decreased exercise.The increasing prevalence of type 2 diab etes in the United States has closely paralleled the increase in childhood obesi ty noted there,but now across the Western world.Besides obesity,the other you th risk factors for type 2 diabetes are:ethnicity,puberty,family history,met abolic syndrome,polycystic ovary syndrome,acanthosis nigricans.Any feature or condition associated with insulin resistance/hyperinsulinemia should alert to s creen youth at increased risk for(pre)type 2 diabetes.Treatment goals are to d ecrease weight and increase exercise,to normalize insulinemia,glycemia and HbA 1c,to control hypertension and hyperlipidemia.The aim of the pharmacological t herapy is to decrease insulin resistance,namely by metformin.Sometimes,insuli n therapy is necessary.
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