Drs. Peterson, Silverstein, Kaufman, and Warren-Boulton have published an update on the management of Type 2 diabetes in youth. This is very timely for this is becoming an important disease for the youth. The factors for high risk group are a body mass index of more than the 85th percentile plus family history and high risk ethnicity.
Increased physical activity along with a healthy diet plus a reduction in weight and blood glucose level can prevent or delay the onset of the disease. The American Academy of Pediatrics does not propose that the high risk group be screened but advised the physicians to closely monitor these patients because early diagnosis maybe helpful.
However The American Diabetes Association recommends screening these patients every two years. It was further suggested that those diagnosed with diabetes receive behavioral interventions to encourage eating healthy and physical activity.
Since the treatment of Type 2 diabetes is different between adults and children because the management for the latter group is focused on lower insulin sensitivity with advancing physical growth and sexual maturity and the ability to do self-care, it is good to tailor the treatment for each patient.
It is not enough to use just diet and exercise because this works only for less than 10% of the afflicted youth. Oral medication or insulin is usually necessary. Treatments of blood goals target, type of insulin dose, self-monitoring frequency, meal planning to promote good nutrition
and physical activity will differ from patient to patient.
Doing all the self-care tasks can make the kids feel different and coping may lead to depression and eating disorder so a social worker or psychologist can help with adjustment to lifestyle changes. While kids should be able to do self-care tasks, they need to be supervised until they are able to do them on their own.