Type 2 diabetes mellitus (T2DM) in children and young people (aged under 18 years) is a more aggressive disease than in older adults and is associated with higher risk of severe long term and potentially life threatening complications (eg, cardiovascular disease, renal disease) compared with other types of diabetes. The worldwide prevalence and annual incidence of T2DM in children and young people is increasing,1 and the National Paediatric Diabetes Audit (NPDA) of England and Wales from 2019-20 showed a prevalence and incidence of 4.5 and 1.7 per 100 000 people 15 years and younger, respectively, and 222 new diagnoses.2 Over the past three years, prevalence has increased by one third, and many children and young people with T2DM are not currently receiving care from paediatric diabetes teams.3 Children and young people who are living with obesity, are of ethnic minority background, and reside in the most deprived areas of the UK, are at increased risk of having T2DM.4
In May 2023, the National Institute for Health and Care Excellence (NICE) published its updated guideline on diagnosis and management of T2DM in children and young people, which was updated in 2015 and again in 2022.5 Evidence for this latest update was reviewed in part to align it with current recommendations …