Children have been diagnosed with Type 1 diabetes for a long time now, but pediatricians are seeing an increase in the number of children diagnosed with Type 2 diabetes. Almost a third of all diabetes cases in children are now Type 2 cases, which generally happens later in life, around the age of 40. "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 diabetes because it isn'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 Academy decided that since they were seeing more patients with this disease they needed to have clear, consistent advice on how to treat them. These guidelines are the first of their kind for children ages 10 to 18 and were developed in conjunction with the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians, and the Academy of Nutrition and Dietetics. The group's first recommendation is to screen all obese children for diabetes, then figure out what type they have.
The importance between diagnosing Type 1 and Type 2 will be the treatment plan, especially when it comes to insulin. Many children who have Type 2 diabetes do not need insulin and will instead be treated with medication that increases their sensitivity to it. Doctor will also highly recommend lots of exercises, as much as an hour a day. Screen time, both computers, television, and other devices, should be limited as well, unless it is related to schoolwork. If doctors aren't initially sure what type of diabetes their patient has, they should start all children off with insulin, as those with Type 1 will always need it.
Dr. Rubina Heptulla, chief of the division of pediatric endocrinology and diabetes at Children's Hospital at Montefiore in the Bronx, sees up to three children a week who are newly diagnosed with diabetes. About half have Type 2 diabetes and she says this is a pediatric epidemic. "I did not see this as a resident or fellow. We would not have had these guidelines 10 years ago because there were not many cases. Now these guidelines are very relevant," says Dr. Heptulla, who was not involved with creating the new guidelines.
In the guidelines pediatricians recommend parents take a large role in combating their child's disease, by regulating diet and exercise, as these simple measures can sometimes reverse the condition. "The way to make a difference is before they develop diabetes," says Dr. Heptulla.
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