Type 2 Diabetes in Latino Youth: A Clinical Update and Current Challenges.

Latino youth have the highest prevalence of overweight and obesity among all ethnic groups and are disproportionally affected by pre diabetes and type 2 diabetes (T2DM). Interventions that effectively reduce the risk of pre diabetes and T2DM in this population are urgently needed. Studies have shown that without any change, 50% of Latino children and adolescents will develop T2DM. This has important public health implications. Few pharmacologic options are approved for use in the pediatric population. The largest clinical trial to date did include a significant sample of Latinos, however the intervention used metformin or rosiglitazone in addition to lifestyle management and did not show meaningful weight loss, with around half of the participants meeting criteria for treatment failure. On the other hand, a smaller trial on surgical treatment of adolescents with severe obesity and T2DM resulted in superior glycemic control, reduced weight, and improvement of other co-morbidities of T2DM in youth. Lastly, culturally tailored programs that focus on building healthy communities appear to be a promising intervention to reduce diabetes risk in Latino youth. This review provides an update on the clinical aspects of T2DM in Latino youth and focuses on management and prevention strategies.