Progress in diagnosis and treatment of pediatric diabetes in China

The global incidence of type 1 diabetes mellitus (T1DM) in children and adolescents aged 0-19 years is about 1 211.9/10 million, with an incidence rate of 149.5/1 million person-years. In China, the incidence of T1DM in children and adolescents aged 0-19 years is about 56/1 million, with an incidence rate of 6.1/1 million person-years. The incidence of type 2 diabetes mellitus (T2DM) in children and adolescents has been rising annually. Epidemiological data shows that the incidence of T2DM among adolescents in the United States increased from 34/100 000 in 2001 to 46/100 000 in 2009 and to 67/100 000 in 2017. In China, the incidence of pediatric T2DM has also shown a significant upward trend, rising from 4.1/100 000 in 1995 to 10.0/100 000 in 2010. The diagnostic criteria for pediatric diabetes in China follow the standards set by the World Health Organization in 2019. Diabetes subtypes related to children include T1DM, T2DM, mixed-type diabetes, and other specific types of diabetes. The typical clinical manifestations of adult diabetes are polydipsia, polyuria, polyphagia, and weight loss (the ‘three P’s and one less’). However, in children with T1DM, these symptoms are more pronounced, while T2DM may present more subtly. Traditional treatment for T1DM primarily involves insulin therapy, but it cannot fundamentally address the issue of impaired pancreatic function. Preventing or delaying β-cell damage and protecting the remaining pancreatic function have become new research directions in T1DM treatment. In addition to traditional insulin therapy and lifestyle interventions, new treatments such as immunotherapy, artificial pancreas, and stem cell transplantation have shown promising clinical results. These advances not only provide new directions for the future treatment of diabetes but also have the potential to transform diabetes from an incurable disease into a treatable one.