By Natasha Persaud
If you have a child with type 2 diabetes, new guidelines from the American Academy of Pediatrics should come as welcome news. Compared to just a few decades ago, when type 2 diabetes was hardly seen in kids and teens, the disease now is rising rapidly among young people, especially among those who are overweight or obese. One in 3 new cases of diabetes in children and adolescents in the U.S. is type 2 diabetes.
The spike poses challenges to many health care providers who find themselves ill-equipped to treat an “adult” disease in kids. Most medications used for type 2 diabetes have been tested only in adults, and there is scant research on managing the disease in children ages 10 to 18.
To create the treatment guidelines, the American Academy of Pediatrics gathered a panel of experts who reviewed available scientific research on diabetes. Below, are the key recommendations, published in the journal, Pediatrics.
Health care providers should consider:
1. starting insulin therapy in children who experience ketosis or ketoacidosis (dangerous complications due to low insulin), kids in whom type 1 and type 2 diabetes can't be distinguished, and kids with blood glucose at or above 250 mg/dL or HbA1c greater than 9 percent;
2. initiating a lifestyle modification program and metformin medication for other patients;
3. monitoring blood glucose levels (HbA1c concentrations) every 3 months and modifying treatment if goals are not met;
4. advising finger-stick blood glucose monitoring for patients who are on medications that can cause hypoglycemia (i.e., dangerously low blood sugar levels), are starting or changing diabetes treatment, have not met treatment goals, or have other illnesses;
5. counseling children and their parents on diet and nutrition;
6. advising children and teens to exercise at moderate to vigorous intensity for a total of 60 minutes or more each day and to limit sedentary behaviors such as TV watching and video games to less than 2 hours each day
The authors emphasize that the new report should be used by health care providers in concert with the advice of pediatric specialists and other experts. Parents can play a valuable role by helping children stick to their medication regimen, eat nutritiously and exercise regularly.
All together, good management by the health care team, new research and family efforts can help kids with type 2 diabetes enjoy a better quality of life.
Copeland, K. et al. “Management of Newly Diagnosed Type 2 Diabetes Mellitus (T2DM) in Children and Adolescents.” Pediatrics, January 28, 2013.