The DOI matches its Crossref record; 148 of the 150 references it cites were found in a registry or an index; 20 of the 80 sources its claims cite were checked for support.
Type 2 diabetes in adolescents and young adults
Open accessAbstract
The prevalence of type 2 diabetes in adolescents and young adults is dramatically increasing. Similar to older-onset type 2 diabetes, the major predisposing risk factors are obesity, family history, and sedentary lifestyle. Onset of diabetes at a younger age (defined here as up to age 40 years) is associated with longer disease exposure and increased risk for chronic complications. Young-onset type 2 diabetes also affects more individuals of working age, accentuating the adverse societal effects of the disease. Furthermore, evidence is accumulating that young-onset type 2 diabetes has a more aggressive disease phenotype, leading to premature development of complications, with adverse effects on quality of life and unfavourable effects on long-term outcomes, raising the possibility of a future public health catastrophe. In this Review, we describe the epidemiology and existing knowledge regarding pathophysiology, risk factors, complications, and management of type 2 diabetes in adolescents and young adults.
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Claims the paper makes
27 No full text of the sources · 15 Partly supported · 15 Own interpretation · 13 Sources not found · 4 Couldn’t confirm · 4 No basis given · 2 Not checked yet · 1 Supported · accuracy not yet measured
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In the paper
“However, apparent ethnic differences based on regional variations in prevalence (table 1), have the limitation that the diagnostic criteria and methods of data collection are not always consistent [15][16][17] .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Partly supportedcites [15] Kim, 2010, The clinical characteristics of the newly diagnosed early onset (<40 years old) diabetes in outpatients' clinic, Korean Diabetes J sourceExperimental — accuracy not yet measured
The Discussion reports regional differences in early-onset diabetes prevalence and says differing patient recruitment and data-collection methods could explain discrepancies between studies. It also shows that studies used different age cutoffs, but does not establish that diabetes diagnostic criteria were inconsistent or specifically assess ethnic differences. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [16] Chuang, 2006, Comparisons of the outcomes on control, type of management and complications status in early onset and late onset type 2 diabetes in Asia, Diabetes Res Clin Pract source
- Not checked — no full text of the sourcecites [17] Jimenez-Corona, 2010, Early-onset type 2 diabetes in a Mexican survey: results from the National Health and Nutrition Survey 2006, Salud Publica Mex source
plain- Asserted: passes — The authors put it forward as true.
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- Partly supported
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In the paper
“Such a decrease in second phase insulin secretion would take more than a decade to emerge in most T2DM patients presenting in middle or later life [21][22] .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
What the sources say
- Not checked — no full text of the sourcecites [21] Bagust, 2003, Deteriorating beta–cell function in type 2 diabetes: a long–term model, QJM source
- Partly supportedcites [22] Kahn, 2003, The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes, Diabetologia sourceExperimental — accuracy not yet measured
The intravenous-testing section (p. 8) reports reduced second-phase insulin responses in people at high risk of type 2 diabetes, supporting the claim that this response can decline. It does not say that a comparable decline takes more than a decade in most patients whose diabetes presents in middle or later life; the longitudinal study discussed on p. 7 followed a different, high-risk population for an average of five years. (LLM, conf=0.82)
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“Changes in the intrauterine environment influence development of obesity and type 2 diabetes in adolescents and young adults more strongly than in later life.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > KEY DRIVERS FOR T2DMY Early life determinants
What the sources say
- Not checked — no full text of the sourcecites [31] Reinehr, 2016, Inflammatory markers in obese adolescents with type 2 diabetes and their relationship to hepatokines and adipokines, J Pediatr source
- Partly supportedcites [32] Vrachnis, 2012, Impact of maternal diabetes on epigenetic modifications leading to diseases in the offspring, Exp Diabetes Res sourceExperimental — accuracy not yet measured
Section 3 (page unavailable) says exposure to a diabetic intrauterine environment contributes to obesity and diabetes in offspring. Section 2.2 reports higher diabetes incidence among exposed offspring in all age groups, but neither passage says the effect is stronger in adolescents and young adults than later in life. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
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The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Maternal undernutrition and overnutrition are associated with a greater increased risk of obesity and type 2 diabetes in adolescence and early adulthood than in later life ,31,32 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > KEY DRIVERS FOR T2DMY Early life determinants
What the sources say
- Not checked — no full text of the sourcecites [31] Reinehr, 2016, Inflammatory markers in obese adolescents with type 2 diabetes and their relationship to hepatokines and adipokines, J Pediatr source
- Partly supportedcites [32] Vrachnis, 2012, Impact of maternal diabetes on epigenetic modifications leading to diseases in the offspring, Exp Diabetes Res sourceExperimental — accuracy not yet measured
Section 3 (page unavailable) links exposure to a diabetic intrauterine environment with greater offspring risk of obesity and diabetes. It does not address maternal undernutrition or show that the risk is greater in adolescence and early adulthood than later in life. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“However, IR is directly related to an increased percentage of fat in muscle and liver in all age groups 6 ,”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
What the sources say
- Could not verifycites [6] Mayer-Davis, 2017, Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012, N Engl J Med sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) says that changes in obesity prevalence among youths may contribute to changes in insulin resistance. It does not address fat percentages in muscle or liver, a direct relationship with insulin resistance, or all age groups; searches for muscle and liver fat found no such passage. (LLM, conf=0.76)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
- Could not verify
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In the paper
“Increased circulating concentrations of these pro-inflammatory markers are reported in adolescents with T2DM 30 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
What the sources say
- Partly supportedcites [30] Lumeng, 2011, Inflammatory links between obesity and metabolic disease, J Clin Invest sourceExperimental — accuracy not yet measured
The Antiinflammatory therapies for metabolic disease section (page unavailable) reports that treatment in type 2 diabetes decreases systemic inflammatory markers, supporting a general link between these markers and the disease. The Pancreatic islets section discusses adolescents only in relation to adipose tissue, not circulating marker concentrations in adolescents with type 2 diabetes. That population-specific finding is not supported by our copy. (LLM, conf=0.77)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
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In the paper
“Thus, in a large prospective study, rapid weight gain during the first 4 months of life was associated with an increased risk of overweight at age 7 years 34 ,”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > KEY DRIVERS FOR T2DMY Early life determinants
What the sources say
- Partly supportedcites [34] Jiang, 2013, Early life factors and type 2 diabetes mellitus, J Diabetes Res sourceExperimental — accuracy not yet measured
The 'Catch-Up Growth' section links early growth to increased fat gain, and the 'Lactation—Overnutrition' section links neonatal overfeeding to later overweight in animal models. Neither section reports a large prospective study associating weight gain in the first four months of human life with overweight at age seven; the age-seven finding concerns insulin sensitivity, not overweight. (LLM, conf=0.82)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
- Partly supported
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In the paper
“The widespread use of corn derived fructose syrup as a sweetening agent in 'fizzy' drinks has a substantial impact on development of adiposity, IR, hyperglycaemia and other cardio-metabolic risk factors in the young 42,43 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Diet and obesity
What the sources say
- Partly supportedcites [42] Gow, 2016, The effectiveness of different diet strategies to reduce type 2 diabetes risk in youth, Nutrients sourceExperimental — accuracy not yet measured
Section 5, “Glycemic Index of the Diet” (page unavailable), reports that lower-GI diets can improve body weight and insulin resistance in children, supporting a general link between diet and some of the named risk factors. It does not establish that corn-derived fructose syrup in fizzy drinks is widely used or has a substantial effect on those outcomes in young people. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [43] Bray, 2004, Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity, Am J Clin Nutr source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“including predictions that current funding systems will not be able to accommodate the growing demands for expensive longterm care incurred by the disease complications 3,147,150,151 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Societal impact of T2DMY
What the sources say
- Could not verifycites [3] 2016, Standards of medical care in diabetes—2016 abridged for primary care providers, Clin Diabetes sourceExperimental — accuracy not yet measured
The Older Adults section discusses diabetes complications and care in nursing homes and skilled nursing facilities, but it does not address the cost of that care. Searches for funding capacity and the economic burden of long-term care found no prediction that current funding systems will be unable to meet growing demand. (LLM, conf=0.74)
- Not matchedcites [147]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [150]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Early onset obesity and T2DM have also been identified as particular threats to the capacity of healthcare services across Europe and North America”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Societal impact of T2DMY
What the sources say
- Partly supportedcites [3] 2016, Standards of medical care in diabetes—2016 abridged for primary care providers, Clin Diabetes sourceExperimental — accuracy not yet measured
In “Strategies for Improving Care > Diabetes Care Concepts” (page not provided), the paper says type 2 diabetes is increasing in children and young adults and calls for better coordination between clinical teams. It does not identify early-onset obesity and type 2 diabetes as particular threats to healthcare service capacity in Europe or North America. (LLM, conf=0.83)
- Not matchedcites [147]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [150]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The global prevalence of type 2 diabetes mellitus (T2DM) in adolescents and young adults is dramatically increasing.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Abstract
boosteddirect- Asserted: passes — The authors put it forward as true.
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- Based: unclear — It is unclear why the paper says it holds.
In the paper
“A case-control study of African-American and white Europids found that obese adolescents with T2DM for about 1.5 years have about a 75% decrease of first phase and a 50% decrease of second phase insulin secretion compared with obese non diabetic peers 20 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
What the sources say
- Not checked — no full text of the sourcecites [20] Taha, 2006, Type 2 diabetes mellitus in African-American adolescents: impaired beta-cell function in the face of severe insulin resistance, J Pediatr Endocrinol Metab source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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None of the sources cited for this claim have been checked yet.
In the paper
“Emerging evidence suggests that loss of beta cell function is accelerated in T2DMY.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“T2DM is increasingly diagnosed in children, adolescents and younger adults.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Individuals born in the USA in the year 2000 have a risk for diabetes by age 40 years of approximately 2•5% for men and 5% for women.,These estimates are doubled for Hispanic and black persons suggesting that certain ethnic groups are disproportionately affected 14 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [14] Narayan, 2003, Lifetime risk for diabetes mellitus in the United States, JAMA source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“In the UK, a higher prevalence is reported in people of South Asian, African and African-Caribbean origin compared with white European populations 13 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [13] Haines, 2007, Rising incidence of type 2 diabetes in children in the UK, Diabetes Care source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A study of the age specific incidence of T2DM in the UK reported a significant increase in the proportion of people aged ≤40 years at diagnosis (Figure 2) 12 over a 20 year period.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [12] Holden, 2013, The incidence of type 2 diabetes in the United Kingdom from 1991 to 2010, Diabetes Obes Metab source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The standardized incidence ratio (per 100,000 population) of newly diagnosed T2DM aged <40 years increased from 217 in 1996-2000 to 598 in 2006-2010.12”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [12] Holden, 2013, The incidence of type 2 diabetes in the United Kingdom from 1991 to 2010, Diabetes Obes Metab source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In addition, T2DMY may have a more rapid and disruptive natural history than T2DM presenting later in life, leading to early morbidity and poor quality of life 2 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [2] Copeland, 2013, Management of newly diagnosed type 2 diabetes mellitus (T2DM) in children and adolescents, Pediatrics source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As with older onset type 2 diabetes, the major predisposing risk factors are obesity, family history and sedentary lifestyle.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“However, the speed of onset, severity and interplay of decreased insulin sensitivity and defective insulin secretion during the development of T2DMY may differ from older presentations of T2DM 18 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
What the sources say
- Not checked — no full text of the sourcecites [18] Gungor, 2005, Youth type 2 diabetes: insulin resistance, β-cell failure, or both?, Diabetes Care source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“However, the second phase of nutrient-induced insulin secretion may be compromised earlier in the pathogenic process in younger individuals with T2DM 18,19-.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
What the sources say
- Not checked — no full text of the sourcecites [18] Gungor, 2005, Youth type 2 diabetes: insulin resistance, β-cell failure, or both?, Diabetes Care source
- Not checked — no full text of the sourcecites [19] Druet, 2006, Characterization of insulin secretion and resistance in type 2 diabetes of adolescents, J Clin Endocrinol Metab source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A nationwide screening programme of diabetes among children aged 6 to 18 years, in Taiwan between 1992 and 1999, found an incidence of newly diagnosed T2DM of 6•5 per 100,000 compared with 1.5 per 100,000 for T1DM 7 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [7] Pinhas-Hamiel, 2005, The global spread of type 2 diabetes mellitus in children and adolescents, J Pediatr source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The mechanisms leading to development of T2DMY are similar to those in T2DM amongst older adults.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Physical inactivity amongst youth is associated with increased risk of metabolic syndrome , insulin resistance and type 2 diabetes.[50][51] .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Physical activity
What the sources say
- Not checked — no full text of the sourcecites [50] Troiano, 2008, Physical activity in the United States measured by accelerometer, Med Sci Sports Exerc source
- Not checked — no full text of the sourcecites [51] Riddoch, 2004, Physical activity levels and patterns of 9- and 15-yr-old European children, Med Sci Sports Exerc source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The frequency and severity of complications with T2DMY may limit capacity to work”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Societal impact of T2DMY
What the sources say
- Not matchedcites [147]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Not matched
In the paper
“The mean HbA1c significantly lower in the metformin group compared with the placebo (7.5% vs. 8.6%, respectively)”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Bariatric Surgery
What the sources say
- Not checked — no full text of the sourcecites Jones et al (2002) source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, owing to methodological deficiencies and lack of reliable baseline data, it is difficult to quantify the secular changes in leisure time activity in adolescents and younger adults 45 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Physical activity
What the sources say
- Not checked — no full text of the sourcecites [45] Mayer-Davis, 2006, Dietary intake among youth with diabetes: the SEARCH for Diabetes in Youth Study, J Am Diet Assoc source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The reasons for this rapid failure of both phases of nutrient-stimulated insulin secretion are unclear but suggest that T2DMY may have more aggressive course with faster loss of beta cell function than T2DM presenting later in life.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“and analyses of large databases have confirmed a strong inverse association between BMI and age at diagnosis of T2DM 27 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
What the sources say
- Not checked — no full text of the sourcecites [27] Hillier, 2001, Characteristics of an adult population with newly diagnosed type 2 diabetes: the relation of obesity and age of onset, Diabetes Care source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“while post-partum under nutrition increased the risk of obesity and type 2 diabetes in young adults 35 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > KEY DRIVERS FOR T2DMY Early life determinants
What the sources say
- Not checked — no full text of the sourcecites [35] Stettler, 2002, Infant weight gain and childhood overweight status in a multicenter, cohort study, Pediatrics source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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In the paper
“Metformin plus Rosiglitazone significantly superior to Metformin alone.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Bariatric Surgery
What the sources say
- Not matchedcites TODAY Study Group (2012)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“When T2DM presents in later life the severity of IR is often greater amongst those with a history of protracted and severe obesity, particularly with excess visceral adiposity 28 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
What the sources say
- Not checked — no full text of the sourcecites [28] Kahn, 2006, Mechanisms linking obesity to insulin resistance and type 2 diabetes, Nature source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Physical inactivity is associated with increased risk of obesity.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Physical activity
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Data in youth with type 2 diabetes are limited but nevertheless encouraging with significant improvements in weight and glycaemic indicators as seen in older adults (ref).”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Bariatric Surgery
What the sources say
- Not matchedcites ref
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“54% achieved HbA1c < 7%”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Bariatric Surgery
What the sources say
- Not matchedcites Wittmeier et al (2013)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, accelerated decline of beta cell function appears to make an important contribution to the development of T2DM in early life.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Similarly, in the CARDIA study of 18 to 30 year olds, there was a strong association between physical inactivity and risk of type 2 diabetes , hypertension and metabolic syndrome 51 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Physical activity
What the sources say
- Not checked — no full text of the sourcecites [51] Riddoch, 2004, Physical activity levels and patterns of 9- and 15-yr-old European children, Med Sci Sports Exerc source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“This has emerged as a viable treatment option in individuals with T2DM 144”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Bariatric Surgery
What the sources say
- Not matchedcites [144]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“The prevalence of obesity among children, adolescents and young adults with T2DM is much greater than in older adults (eg.>80% versus 56% in a recent study 26 )”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
What the sources say
- Not checked — no full text of the sourcecites [26] Wilmot, 2014, Early onset type 2 diabetes: risk factors, clinical impact and management, Ther Adv Chronic Dis source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Only 27% of subjects achieved a HbA1c <7%”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Bariatric Surgery
What the sources say
- Not checked — no full text of the sourcecites Yeung et al (2014) source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In the Bogulusa Heart Study of young adults aged 20-38 years, an inverse relationship was observed between leisure time physical activity and risk factors for insulin resistance 50 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Physical activity
What the sources say
- Not checked — no full text of the sourcecites [50] Troiano, 2008, Physical activity in the United States measured by accelerometer, Med Sci Sports Exerc source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Also, T2DM before age 20 years emerges 1-2 years earlier in offspring exposed to hyperglycaemia in utero 31 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > KEY DRIVERS FOR T2DMY Early life determinants
What the sources say
- Not checked — no full text of the sourcecites [31] Reinehr, 2016, Inflammatory markers in obese adolescents with type 2 diabetes and their relationship to hepatokines and adipokines, J Pediatr source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“poor sustainability of responsiveness to oral glucose lowering therapies”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Summary and Future research direction
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“reduced quality of life through visual impairment, frequency of healthcare appointments and lifestyle constraints are prominently cited by younger patients 18”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Societal impact of T2DMY
What the sources say
- Not checked — no full text of the sourcecites [18] Gungor, 2005, Youth type 2 diabetes: insulin resistance, β-cell failure, or both?, Diabetes Care source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While it is tempting to extrapolate the natural history of T2DMY as just an earlier and more rapid form of later-onset T2DM, there are distinctive differences.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Summary and Future research direction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“greater obesity”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Summary and Future research direction
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“early loss of both first and second phases of insulin secretion”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Summary and Future research direction
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“frequently necessitating early introduction of insulin”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Summary and Future research direction
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“alongside often severe insulin resistance”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Summary and Future research direction
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
In the paper
“the economic and sociological sequelae are likely to be greater than for later-onset T2DM 147”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Societal impact of T2DMY
What the sources say
- Not matchedcites [147]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Protracted depression requiring substantial on-going psychological support is common with T2DMY 148”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Societal impact of T2DMY
What the sources say
- Not matchedcites [148]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
- It may state two separate claims as one. 28
- Probably not a substantial claim. 6
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A 20-35 % decline in beta cell function annually in 10-19 year olds has been reported compared to the ~7% loss in older individuals with T2DM 23 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
What the sources say
- Partly supportedcites [23] 2013, Effects of metformin, metformin plus rosiglitazone, and metformin plus lifestyle on insulin sensitivity and β-cell function in TODAY, Diabetes Care sourceExperimental — accuracy not yet measured
The Conclusions report a 20–35% annual decline in β-cell function in the TODAY treatment groups and cite an approximately 7% annual decline in an adult study. The Study design section says TODAY participants were 10–17 years old at randomization, so the cited paper does not establish the claim’s stated 10–19-year-old age range. (LLM, conf=0.83)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Prevalence estimates suggest a 30•5% increase in T2DM amongst US youth aged 10 to 19 years between 2001 and 2009, accounting for prevalence of 0•48 per 1000 in this age group 5 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Supportedcites [5] Dabelea, 2014, Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009, JAMA source
The Results report that, after adjustment for completeness of case ascertainment, type 2 diabetes prevalence rose by 30.5% from 2001 to 2009 and reached 0.48 per 1000 in 2009. The study defines its type 2 diabetes population as youth aged 10–19 years; its estimates come from five US study areas. (LLM, conf=0.95)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Recent data from the SEARCH study showed an annual increase of 7.1% in the incidence of T2DM (9 cases per 100,000 in 2002 -2003 to 12.5 cases per 100,000 in 2011-2012) amongst 10-19 year olds in the USA with significant relative increases in all ethnic groups compared to non Hispanic Whites 6 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Partly supportedcites [6] Mayer-Davis, 2017, Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012, N Engl J Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelationaln = 9- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“and younger people with T2DM can have much higher (up to 3 times) amounts of liver fat compared with BMI-matched non-diabetic controls and compared with presentations of T2DM in middle and later life 24,”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
What the sources say
- Could not verifycites [24] Bacha, 2013, Progressive deterioration of β-cell function in obese youth with type 2 diabetes, Pediatr Diabetes sourceExperimental — accuracy not yet measured
The Results section (‘Study subjects and fasting metabolic profile’; page unavailable) reports abdominal fat and hepatic insulin sensitivity, but not liver-fat amounts. Searches for liver fat, intrahepatic fat, and a threefold difference found no comparison with BMI-matched non-diabetic controls or older people with type 2 diabetes in our copy. (LLM, conf=0.76)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Physical activity declines further in adolescents compared with younger children and only a small proportion meet recommended levels, eg recent surveys in Europe and North America indicate that about 80% of 13-15 year-olds undertake moderate or vigorous exercise for less than 60 minutes per day, with girls being less active than boys [46][47][48][49] .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Physical activity
What the sources say
- Partly supportedcites [46] Dollman, 2005, Evidence for secular trends in children's physical activity behaviour, Br J Sports Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [47] Kautiainen, 2005, Use of information and communication technology and prevalence of overweight and obesity among adolescents, Int J Obes source
- Not checked — no full text of the sourcecites [48] Hallal, 2012, Global physical activity levels: surveillance progress, pitfalls, and prospects, Lancet source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Increasing consumption of calorie dense foods, and sugar-rich drinks and decreased physical activity are the main contributors amongst youth 39 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Diet and obesity
What the sources say
- Partly supportedcites [39] Steyn, 2004, Diet, nutrition and the prevention of type 2 diabetes, Public Health Nutr sourceExperimental — accuracy not yet measured
The Physical inactivity section identifies inactivity as a risk factor for type 2 diabetes, and Recommendations and policy implications advises a diet low in free sugars alongside regular activity. The paper notes younger onset of diabetes, but these passages do not establish that calorie-dense foods and sugar-rich drinks, together with inactivity, are the main contributors specifically among youth. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Indeed, the SEARCH study showed few differences in macronutrient or fibre intake between youths with T1DM versus T2DM, but those with T2DM consumed twice the amount of sweetened beverages 44 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Diet and obesity
What the sources say
- Could not verifycites [44] Hu, 2010, Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence, Physiol Behav sourceExperimental — accuracy not yet measured
The Prospective cohort studies sections discuss sweetened-beverage intake and diabetes risk, but do not report the SEARCH study’s comparison of youths with type 1 versus type 2 diabetes. Searches for SEARCH, macronutrient and fibre intake, and the claimed twofold beverage difference found no passage addressing that comparison. (LLM, conf=0.75)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The global pandemic of overweight and obesity now affects 36.9% of men,38% of women, 23.8% of boys and 22.6% of girls 37 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Diet and obesity
What the sources say
- Partly supportedcites [37] Yessoufou, 2011, Maternal diabetes in pregnancy: early and long-term outcomes on the offspring and the concept of “metabolic memory”, Exp Diabetes Res sourceExperimental — accuracy not yet measured
Section 8 says obesity prevalence is increasing worldwide and that the pandemic affects children and adults. It does not give the claimed percentages for men, women, boys, or girls; searches for those figures and for global prevalence by sex and age found no such estimates in our copy. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although the causes of obesity in children and adolescents are complex, obesity is clearly a driver for the upsurge in T2DMY and changes in lifestyle account for much of the increased prevalence of obesity and T2DM in pre-and early-adult life 38 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Diet and obesity
What the sources say
- Partly supportedcites [38] Ng, 2014, Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013, Lancet sourceExperimental — accuracy not yet measured
The Discussion (page not provided) says rising overweight and obesity can drive up diabetes, and the Results report increasing obesity at younger ages. It does not establish a rise in young-onset type 2 diabetes specifically. The Discussion lists diet and physical activity among possible contributors to obesity but explicitly says the analysis does not measure their relative contributions, so it does not support the claim that lifestyle changes explain much of the increase. (LLM, conf=0.88)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Compared with non-obese adolescents, obese adolescents are reported to have chronically increased circulating free fatty acids (FFA) which decrease insulin sensitivity and may contribute to increased reactive oxygen species and impair insulin secretion 29 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
What the sources say
- Partly supportedcites [29] Cree-Green, 2013, Etiology of insulin resistance in youth with type 2 diabetes, Curr Diab Rep sourceExperimental — accuracy not yet measured
The “Mechanisms of Insulin Resistance in Children with T2DM” section reports increased FFA concentrations in obese children and describes how FFA can decrease insulin sensitivity, increase reactive oxygen species, and lead to defective insulin secretion. It does not establish that the FFA elevation is chronic or explicitly compare FFA concentrations in obese and non-obese adolescents. No page number is available in our copy. (LLM, conf=0.86)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Onset of diabetes at a younger age is associated with longer disease exposure and increased risk for chronic complications affecting more individuals of working age and accentuating adverse societal impact of the disease.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The global prevalence of adults with diabetes is around 8% (>90% of whom have T2DM)with projections to increase to over 10% by 2040 1 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > INTRODUCTION
What the sources say
- Not matchedcites [1] 2015
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Earlier onset leads to longer lifetime exposure to hyperglycaemia and consequently greater propensity for long term complications.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > INTRODUCTION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These estimates are doubled for Hispanic and black persons suggesting that certain ethnic groups are disproportionately affected 14 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [14] Narayan, 2003, Lifetime risk for diabetes mellitus in the United States, JAMA source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The International Diabetes Federation estimated that in the year 2000 young adults aged 20-39 years with T2DM numbered approximately 23 million worldwide (13% of 177 million adults with diabetes 8 ).”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Not matchedcites [8] 2000
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedn = 23- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Evidence is also accumulating that young diabetic cohorts represent an aggressive phenotype leading to premature development of complications with an adverse impact on quality of life and unfavourably influencing long term outcomes, raising the possibility of a future public health catastrophe.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Abstract
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“By 2013 this had increased to an estimated 63 million (16% of 382 million adults with T2DM [9][10][11] ), the biggest increases being in Africa, South East Asia and the Western Pacific regions (Figure 1).”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
What the sources say
- Not matchedcites [9] 2003
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [10] 2006
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [11] 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover,T2DMY affects more individuals of working age which further accentuates its adverse societal impact.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > INTRODUCTION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While obesity is clearly a prominent risk factor for T2DMY, studies focussed on IR, lipid metabolism and inflammation corroborate evidence in the previous section suggesting that the development of 'diabetic' hyperglycaemia in this age group appears to be more strongly dependent on beta-cell failure than T2DM in later life.”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although aerobic exercise can delay or prevent the development of type 2 diabetes in older adults, the expected metabolic benefits derived from aerobic activity are comparatively less in those with T2DMY 52 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Physical activity
What the sources say
- Not checked — no full text of the sourcecites [52] Gustat, 2002, Relation of self-rated measures of physical activity to multiple risk factors of insulin resistance syndrome in young adults: the Bogalusa Heart Study, J Clin Epidemiol source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“there is now evidence that it is safe and effective in obese adolescents [145][146] .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Bariatric Surgery
What the sources say
- Not matchedcites [145]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [146]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Separate observational studies in adolescents of different ethnic groups have similarly confirmed the early deterioration of beta-cell function with T2DMY: this was closely associated with the severity of insulin resistance (IR) in African-American adolescents but less so in white Europids and South Asians 25,26 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > PATHOPHYSIOLOGY Decline in beta cell function
What the sources say
- Not checked — no full text of the sourcecites [25] Mohan, 2013, Associations of β-cell function and insulin resistance with youth-onset type 2 diabetes and prediabetes among Asian Indians, Diabetes Technol Ther source
- Not checked — no full text of the sourcecites [26] Wilmot, 2014, Early onset type 2 diabetes: risk factors, clinical impact and management, Ther Adv Chronic Dis source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Regular consumption of sweetened beverages increases energy consumption by about 10%, while increased portion sizes, access to fast foods and targeted advertising of snacks increase adiposity in children, adolescents and young adults 40,41 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Diet and obesity
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Data in youth with type 2 diabetes are limited but nevertheless encouraging with significant improvements in weight and glycaemic indicators as seen in older adults (ref).”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Bariatric Surgery
What the sources say
- Not matchedcites ref
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“In contrast, a relationship between the degree of obesity and the extent of IR has not been a consistent finding in studies of adolescents with T2DM, and there are insufficient data to determine the involvement of visceral adiposity in this age group 19 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Obesity induced mechanisms
What the sources say
- Not checked — no full text of the sourcecites [19] Druet, 2006, Characterization of insulin secretion and resistance in type 2 diabetes of adolescents, J Clin Endocrinol Metab source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Nevertheless, better transportation, television viewing and video games all contribute to sedentary behaviours 45 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Physical activity
What the sources say
- Not checked — no full text of the sourcecites [45] Mayer-Davis, 2006, Dietary intake among youth with diabetes: the SEARCH for Diabetes in Youth Study, J Am Diet Assoc source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The T2DMY phenotype has a stronger family history”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Summary and Future research direction
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“early onset and rapid progression of micro-and macrovascular complications”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Summary and Future research direction
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The continued escalation of obesity and T2DM in young adults also impinges on the lives of other family members, friends, work colleagues, communities and the prosperity of localities where prevalence is particularly high 147,149 .”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > Societal impact of T2DMY
What the sources say
- Not matchedcites [147]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [149]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The paper relies on this without support.
The cited studies' findings can be generalised to the broader population of adolescents and young adults with type 2 diabetes.
“Increasing numbers of children, adolescents and young adults with T2DM have been reported across most regions of the world.”
The authors state this as an assumption.
The age cutoff of 40 years defines a biologically and clinically meaningful group for the purposes of this review.
“For this review we have defined T2DMY as onset of type 2 diabetes ( ADA and WHO criteria 3,4 ) in adolescents and young adults up to age 40 years excluding secondary diabetes (drug-or chemicalinduced, exocrine pancreas disease, genetic defects), MODY, gestational diabetes and rare forms of diabetes.”
The paper relies on this without support.
Pregnancy is not uncommon in this age group with T2DMY.
“Pregnancy is not an uncommon occurrence in this age group”
The paper relies on this without support.
T2DMY can adversely affect maternal and foetal outcomes.
“the presence of T2DMY can adversely affect maternal and foetal outcomes ( Add reference).”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
“an annual increase of 7.1% in the incidence of T2DM”
§ TYPE 2 DIABETES IN ADOLESCENTS AND YOUNG ADULTS AUTHORS > EPIDEMIOLOGY
“(9 cases per 100,000 in 2002 -2003 to 12.5 cases per 100,000 in 2011-2012)”
Citations
Cites
Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., Mullany, E. C., Biryukov, S., Abbafati, C., Abera, S. F., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60460-8 · Cited by 11,952
Physical Activity in the United States Measured by Accelerometer
TROIANO, R. P., BERRIGAN, D., DODD, K. W., MÂSSE, L. C., TILERT, T., & MCDOWELL, M. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31815a51b3 · Cited by 7,638
Global physical activity levels: surveillance progress, pitfalls, and prospects
Hallal, P. C., Andersen, L. B., Bull, F. C., Guthold, R., Haskell, W., & Ekelund, U. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60646-1 · Cited by 5,711
Mechanisms linking obesity to insulin resistance and type 2 diabetes
Kahn, S. E., Hull, R. L., & Utzschneider, K. M. (2006) · Nature · doi:10.1038/nature05482 · Cited by 5,448
The global obesity pandemic: shaped by global drivers and local environments
Swinburn, B. A., Sacks, G., Hall, K. D., McPherson, K., Finegood, D. T., Moodie, M. L., & Gortmaker, S. L. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60813-1 · Cited by 4,888
Childhood obesity: public-health crisis, common sense cure
Ebbeling, C. B., Pawlak, D. B., & Ludwig, D. S. (2002) · The Lancet · doi:10.1016/s0140-6736(02)09678-2 · Cited by 2,980
Hotamisligil, G. S., Peraldi, P., Budavari, A., Ellis, R., White, M. F., & Spiegelman, B. M. (1996) · Science · doi:10.1126/science.271.5249.665 · Cited by 2,630
Inflammatory links between obesity and metabolic disease
Lumeng, C. N., & Saltiel, A. R. (2011) · Journal of Clinical Investigation · doi:10.1172/jci57132 · Cited by 2,319
Kahn, S. E. (2003) · Diabetologia · doi:10.1007/s00125-002-1009-0 · Cited by 2,166
Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity
Bray, G. A., Nielsen, S. J., & Popkin, B. M. (2004) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/79.4.537 · Cited by 1,990
Cited by
Sorted by citations
Ahmad, E., Lim, S., Lamptey, R., Webb, D. R., & Davies, M. J. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01655-5 · Cited by 1,120
Physical activity behaviours in adolescence: Current evidence and opportunities for intervention
van Sluijs, E. M. F., Ekelund, U., Crochemore-Silva, I., Guthold, R., Ha, A., Lubans, D., Oyeyemi, A. L., Ding, D., & Katzmarzyk, P. T. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01259-9 · Cited by 919
Iron Homeostasis and Ferroptosis in Human Diseases: Mechanisms and Therapeutic Prospects
Ru, Q., Li, Y., Chen, L., Wu, Y., Min, J., & Wang, F. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-01969-z · Cited by 724
Bhatti, J. S., Sehrawat, A., Mishra, J., Sidhu, I. S., Navik, U., Khullar, N., Kumar, S., Bhatti, G. K., & Reddy, P. H. (2022) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2022.03.019 · Cited by 753
Trends in diabetes treatment and control in U.S. adults, 1999-2018
Fang, M., Wang, D., Coresh, J., & Selvin, E. (2021) · New England Journal of Medicine · doi:10.1056/nejmsa2032271 · Cited by 690
Metadata
- Authors
- Lascar, N., Brown, J., Pattison, H., Barnett, A. H., Bailey, C. J., & Bellary, S.
- Affiliations
- Aston University (GB)
- Heart of England NHS Foundation Trust (GB)
- Corresponding author
- Bellary, Srikanth
- Venue
- The Lancet Diabetes & Endocrinology
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 6
- Issue
- 1
- Pages
- 69-80
- ISSN
- 2213-8587 (ISSN-L)
- OpenAlex
- W2748764116
- Cited by
- 824
- References
- 150
- Citations by year
- 2026: 73 · 2025: 118 · 2024: 112 · 2023: 118 · 2022: 134 · 2021: 107 · 2020: 99 · 2019: 44 · 2018: 17
- FWCI
- 6.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet Diabetes & Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Aston Publications Explorer (Aston University) (acceptedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, youth-onset type 2 diabetes, adolescents, young adults, obesity, family history (medicine), sedentary lifestyle, diabetes risk factors, diabetes complications, disease pathophysiology, diabetes management, quality of life
- MeSH terms
- Adolescent, Adult, Diabetes Mellitus, Type 2, Female, United Kingdom, Humans, Male, Quality of Life, Prevalence, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-01, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-01 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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