The changing face of diabetes in America

Emerg Med Clin North Am. 2014 May;32(2):319-27. doi: 10.1016/j.emc.2013.12.004.


So much has changed in the field of diabetes diagnosis and management in the United States. Unhealthy lifestyle choices have hastened an epidemic of childhood obesity, causing a paradigm shift in how childhood diabetes is conceptualized. Once thought a consequence of obesity, sedentary lifestyle, and genetics, diabetes with onset in adults has been found to have a variant with autoimmunity. As the lines among adult-onset, child-onset, and type 1 and type 2 diabetes mellitus become more blurred, best practices in management and prevention become more complicated. This article highlights key points regarding 2 variants, juvenile-onset type 2 diabetes mellitus and latent autoimmune diabetes of adults.

Keywords: Autoimmune; Childhood; Diabetes; Epidemic; LADA; Obesity.

Publication types

  • Review

MeSH terms

  • Age Distribution
  • Blood Glucose / metabolism
  • Diabetes Mellitus* / epidemiology
  • Diabetes Mellitus* / metabolism
  • Diabetes Mellitus* / therapy
  • Disease Management*
  • Humans
  • Insulin / metabolism
  • Morbidity / trends
  • Prognosis
  • Sex Distribution
  • United States / epidemiology


  • Blood Glucose
  • Insulin