New guides for caring for diabetic children

By ACSH Staff — Jan 30, 2013
The American Academy of Pediatrics has issued the first-ever guidelines for type 2 diabetic children between the ages of 10 and 18.

The American Academy of Pediatrics has issued the first-ever guidelines for type 2 diabetic children between the ages of 10 and 18.

As long as diabetes has been diagnosed, children have almost always had Type 1 diabetes, in which the body s insulin-secreting cells in the pancreas have been destroyed. Consequently, it fails to make enough insulin to process glucose in the blood, and the only treatment was injected insulin. But now, doctors are seeing an increasing number of children with obesity and type 2 diabetes, in which enlarged fat cells impede the body s ability to utilize insulin to break down sugars.

According to the CDC, in 1980 only seven percent of kids between the ages of six and 11 were obese, while by 2008 that number jumped by 20 percent. Similarly, in adolescents aged 12 to 19, the number grew from five percent to 19 percent. Overall, more than one-third of children and adolescents are overweight or obese. As a result, obesity-related illnesses such as type 2 diabetes have increased in kids.

We re seeing it much more than we did before, says Dr. Janet Silverstein, co-author of the new American Academy of Pediatrics guidelines on diabetes and professor of pediatrics at the University of Florida. Many pediatricians were never trained in managing Type 2 because it just wasn t a disease we used to see. It was a disease of adulthood. But as we re seeing more obesity in kids, we re seeing adult diseases in childhood.

The guidelines were developed in collaboration with the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians and the Academy of Nutrition and Dietetics. They emphasize the importance of distinguishing between type 1 and type 2 to determine an appropriate treatment plan. They recommended that children with type 2 diabetes get at least 60 minutes of exercise a day and non-academic "screen time" including video games, television and computer usage should be less than two hours a day.

Also, for kids who need treatment, the anti-diabetic drug metformin is advised along with lifestyle modification programs that encourage nutrition and physical activity. The American Academy of Pediatrics recommended other rules for monitoring young patients' glycemic levels. For example, hemoglobin A1c levels, which reflect the general status of blood sugars over the past few months, should be checked every three months.

While it s disturbing to see type 2 diabetes rearing its ugly head among schoolkids and teens, some comfort should be taken from the fact that the rampant rise in obesity in the last decade seems to be slowing, possibly even reversing, said ACSH s Dr. Gilbert Ross. It s true enough, though, that it was quite unusual to see a child with type 2 diabetes when I was in practice.