# Prediction Models for Diabetes in Children and Adolescents: A Review
## 3 Prediction Models for Type 2 Diabetes (T2D)  
As already mentioned, T2D is the leading cause of diabetes worldwide and is rapidly increasing, especially among children and adolescents. In the past ten years, the prevalence of T2 DM has increased by more than two-fold [43]. The research on diabetes in adolescents, after adjustment for sex, race, or ethnic group, shows that the relative annual increase in incidence of T2D is 4.8% and is almost three-fold to T1D [44]. Research by [PERSON] et al. [33] has shown that there is an inverse relationship between the age of T2D onset and complication risk and mortality: T2D in children and adolescents has a worse prognosis compared to T2D that develops in adults. Therefore, timely diagnosis is crucial to preventing or delaying complications and improving health outcomes. The study of [PERSON] et al. [45] assessed the global burden of T2D among adolescents from 1990 to 2019 using data from the GBD 2019, encompassing 204 countries and territories. The findings reveal a significant increase in the global incidence and disability-adjusted life years DALY rates for T2D, with mortality rates showing a modest rise. In [46], it is stated that youth-onset T2D is becoming increasingly common globally and is characterized by a more severe and aggressive course compared to adult-onset diabetes. It is associated with limited treatment options, poorer responses to therapy, and an increased risk of complications at an early age. Therefore, research into the prevalence, pathogenesis, treatment challenges, and phenotypes of T2D in children and adolescents is of critical importance [47]. The pathophysiology of T2D in children and adolescents differs significantly from adult-onset cases, necessitating early identification of at-risk individuals, understanding unique phenotypes, and developing targeted prevention and treatment strategies. The study [48] showed that the effects of treatment and lifestyle interventions in children and adolescents with pre-diabetes or newly diagnosed T2D yielded limited health outcomes compared to those in adults. Type 2 diabetes (T2 DM) is a complex and chronic metabolic disorder characterized by insulin resistance, impaired insulin secretion, and hyperglycemia [49]. The disease has a heterogeneous etiology and risk factors at the social level and behavioral, environmental, and genetic susceptibility [50]. It is associated with serious complications, but the early diagnosis and initiation of therapy may prevent or delay the onset of long-term complications. Chronic complications of diabetes include the development of cardiovascular disease [50], end-stage kidney disease, retinopathy leading to blindness [51], and limb amputations. All these complications contribute to excess morbidity and mortality in patients with diabetes mellitus, with mortality risk increasing over time and with age [52]. Recent studies show that pre-diabetes also increases the risk of cancer [53]. Given the rising incidence and complications of type 2 diabetes, early identification and prevention are crucial. The timely detection of susceptibility to diabetes, better diagnostic criteria, and early identification of individuals with T2D, preferably during younger adolescent years, and as a new management strategy, are essential. There is an urgent need for targeted, gender- and age-specific prevention strategies, healthier lifestyle promotion, and improved management of T2D and obesity, which will help children with T2D to live a long and healthy life [54]. Proactive preventive strategies and aggressive management are critical for minimizing complications and improving long-term outcomes [55]. The study of [PERSON] et al. [56] reviewed and evaluated the methodology and reporting practices used to develop risk prediction models for detecting undiagnosed (prevalent) type 2 diabetes and predicting future (incident) type 2 diabetes.