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J Pediatr (Rio J) 2003;79(3):201-8: diabetes melito tipo 2, adolescente, epidemiologia.
Objetivo: análise crítica dos estudos sobre a epidemiologia, fisiopatologia, diagnóstico e tratamento do DM2 no jovem.
Métodos: revisão da literatura nos últimos 10 anos, através de pesquisa no banco de dados Medline, utilizando os termos "diabetes do tipo 2 no jovem".
Resultados: a fisiopatologia do DM2 no jovem é semelhante à do adulto, e compreende tanto a resistência à ação da insulina como uma alteração na função da célula beta-pancreática. O antecedente familiar para DM2, a presença de obesidade, a acanthosis nigricans, o peptídeo C de jejum superior a 0,6 ng/ml, a ausência de auto-anticorpos antiilhotas pancreáticas, em combinações variáveis, são pontos importantes para o diagnóstico desse tipo de DM. Cinco a 25% dos jovens com esse tipo de DM podem apresentar cetoacidose no diagnóstico. Nesses pacientes, o tratamento inicial com insulina é possível de ser descontinuado durante a evolução. A aderência à dieta e ao exercício físico são os elementos mais importantes do tratamento destes adolescentes.
Conclusão: como a obesidade nos jovens tem aumentado, tanto em países industrializados como nos países em industrialização, o DM2 no jovem pode ser considerado um problema emergente também na nossa população.
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