ABSTRACT
Type 2 diabetes, the predominant type of diabetes in adults, was pre-
viously thought to seldom develop in children and adolescents. It is,
however, rapidly emerging not only in children and adolescents of par-
ticular high-risk ethnic groups but also in Caucasians in parallel with a
change of lifestyle in recent decades. Furthermore, type 2 diabetes is
now the major type of diabetes in children and adolescents in some
high-risk ethnic groups.1-9 In Asian countries, lifestyles of children and
adolescents, as well as those of adults, have changed rapidly, resulting in
less physical activity and more fat intake. Consequently, obesity, which
is a major risk factor for type 2 diabetes, has steeply increased in chil-
dren and adolescents.10,11 The threshold of body mass index (BMI) for
the risks of cardiovascular diseases and type 2 diabetes (which are based
on insulin resistance) is lower in Asian populations than Caucasian pop-
ulations, suggesting a genetic predisposition to insulin resistance in
Asian populations.12,13 Loading of these environmental and genetic risk
factors for type 2 diabetes in Asian populations is reflected both by the
high frequency of childhood and adolescent type 2 diabetes and by its
rapid increase in Asian populations, shown by some population-based
and hospital-based studies.
