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Review
. 2025 Nov;68(11):2374-2385.
doi: 10.1007/s00125-025-06450-2. Epub 2025 Jun 17.

Metabolic disorders in young people around the world

Sirisha Kusuma Boddu  1 , Cosimo Giannini  2 , M Loredana Marcovecchio  3   4
Affiliations
Review

Metabolic disorders in young people around the world

Sirisha Kusuma Boddu et al. Diabetologia. 2025 Nov.

Abstract

Youth-onset metabolic diseases, including obesity and type 1 and type 2 diabetes, and their associated cardiometabolic complications represent a major global health challenge. The incidence and prevalence of these conditions vary across regions, with rising trends and a heavier burden observed in middle- and low-income countries. Diet, physical activity and lifestyle choices are key factors in the development and progression of metabolic diseases during childhood and adolescence, along with additional risk factors such as genetic predisposition, ancestry, ethnicity, lifetime events (i.e. puberty) and other environmental factors. Disparities in access to healthcare, diagnostic and management capabilities and treatment options across the world affect outcomes, contributing to high morbidity and mortality rates, particularly in low-resource settings. Compared with onset during adulthood, an early diagnosis of metabolic diseases is associated with a higher risk and severity of complications, including adverse vascular outcomes and premature mortality. Although clinical signs of cardiovascular complications typically appear in adulthood, they are the result of a long, subclinical disease process that can begin in childhood and adolescence. This underscores the need for early prevention strategies and effective treatments to reduce the short- and long-term health impacts of these conditions. Addressing the rising prevalence of metabolic diseases, especially among vulnerable populations, requires comprehensive, culturally tailored actions that consider the available resources in diverse settings.

Keywords: Cardiometabolic; Equity, diversity and inclusion; Obesity; Review; The metabolic syndrome; Type 1 diabetes; Type 2 diabetes; Youth.

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Conflict of interest statement

Funding: MLM’s work is supported by Breakthrough T1D (formerly known as JDRF) (3-SRA-2024-1600-S-B and 3-SRA-2023-1422-S-B). Authors’ relationships and activities: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Contribution statement: All authors were responsible for drafting the article and revising it critically for important intellectual content. All authors approved the version to be published.

Figures

Fig. 1
Fig. 1
Life course of metabolic diseases in young people. The figure summarises the main risk factors acting during prenatal life, infancy, childhood and adolescence that contribute to the development of metabolic diseases, such as obesity and diabetes, as well as associated cardiometabolic complications. This figure is available as part of a downloadable slideset
Fig. 2
Fig. 2
Most recent data available on the incidence of type 2 diabetes in youth ranked by region and ethnicity. Reproduced without modifications from the IDF diabetes atlas, 10th edition [39], under the terms of the CC BY-NC-ND 4.0 licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). This figure is available as part of a downloadable slideset
Fig. 3
Fig. 3
Incidence of type 1 diabetes in youth between 2000 and 2022 ranked by region. Reproduced without modifications from Hormazábal‐Aguayo et al [44] under the terms of the CC BY-NC-ND 4.0 licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). This figure is available as part of a downloadable slideset
Fig. 4
Fig. 4
Strategies to reduce the burden of youth-onset metabolic diseases. This figure is available as part of a downloadable slideset
See this image and copyright information in PMC

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