{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:55:02Z","timestamp":1793044502102,"version":"4.5.0"},"reference-count":44,"publisher":"Korean Pediatric Society","issue":"8","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-cep.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Pediatr"],"published-print":{"date-parts":[[2026,8,15]]},"abstract":"<jats:p>Youth-onset type 2 diabetes mellitus (T2DM) is a rapidly growing pediatric metabolic disorder that parallels the global childhood obesity epidemic. Despite multiple population-based registries and a global meta-analysis documenting near-universal obesity at the time of a T2DM diagnosis, no integrated synthesis spanning 25 years and including diverse populations has been performed. Here we conducted a systematic review of PubMed and Scopus (January 2000 to March 2025) using longitudinal data from population-based registries in the USA (SEARCH), Canada (Manitoba), England and Wales (National Paediatric Diabetes Audit), Israel, Australia, and New Zealand as well as cross-sectional burden from a global meta-analysis (53 studies, n=8,942) and national audits. Study quality was appraised using the Newcastle-Ottawa Scale and A Measurement Tool to Assess Systematic Reviews v2. All registries showed a temporally parallel increase in the incidence of pediatric obesity and youth-onset T2DM. In the USA, the T2DM incidence rose 79% (3.8 \u2192 6.8 per 100,000\/yr, 2002\u20132018); in Manitoba, it nearly doubled (16.0 \u2192 31.1 per 100,000\/yr, 2009\u20132018); and Israel showed a 441% rise (0.63 \u2192 3.41 per 100,000\/yr, 2008\u20132019). The global pooled obesity prevalence at the T2DM diagnosis was 75.3% (95% confidence interval, 72.1%\u201378.5%), with approximately 41,600 new youth cases annually worldwide. Once-weekly semaglutide 2.4 mg (STEP TEENS trial) reduced the average body mass index by 16.1% at 68 weeks with concurrent glycemic improvement, while bariatric surgery achieved 95% T2DM remission at 3 years in adolescents (Teen-LABS cohort). Multicontinental evidence confirmed a robust temporally consistent obesity\u2013T2DM link; obesity precedes T2DM at the population level and is present in approximately 75% of affected youths at diagnosis worldwide. Weight-reduction interventions, particularly glucagon-like peptide-1 receptor agonists and bariatric surgery, offer meaningful glycemic benefits; however, primary prevention of childhood obesity remains the most powerful strategy to arrest this epidemic.<\/jats:p>","DOI":"10.3345\/cep.2026.01228","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T03:28:26Z","timestamp":1784518106000},"page":"622-635","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Linking pediatric obesity to youth-onset type 2 diabetes: integrated longitudinal and cross-sectional evidence from population-based studies worldwide"],"prefix":"10.3345","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7145-6561","authenticated-orcid":true,"given":"Ashraf T.","family":"Soliman","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6851-0654","authenticated-orcid":true,"given":"Fawzia","family":"Alyafei","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-6511","authenticated-orcid":true,"given":"Nada","family":"Alaaraj","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7012-5285","authenticated-orcid":true,"given":"Noor","family":"Hamed","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7044-2010","authenticated-orcid":true,"given":"Shayma","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7941-3809","authenticated-orcid":true,"given":"Ahmed","family":"Elawwa","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1897","reference":[{"key":"ref1","first-page":"2627","volume-title":"Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128*9 million children, adolescents, and 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