More Cases of Type 2 Diabetes Increasing in Children, Adolescents
Posted on: Friday, 27 June 2008, 21:01 CDT
By Jeanine Kendle
The Centers for Disease Control and Prevention states that, "diabetes is one of the most common chronic diseases in children and adolescents; about 151,000 people below the age of 20 years have diabetes."
Previously, diabetes acquired during childhood would be Type 1, also known as insulin-dependent or juvenile-onset diabetes. The last 2 decades has found an increase in Type 2 diabetes, a disease previously diagnosed in 40-year-old adults, and thus previously known as adult-onset diabetes.
Type 2 diabetes is diagnosed when the body develops a resistance to insulin and no longer uses insulin adequately. Though the body still has a demand for insulin and though not used properly, the pancreas gradually loses its ability to produce sufficient amounts of insulin to regulate blood sugar.
Children and adolescents between the ages of 10 and 19 years with a strong family history of Type 2 diabetes and have insulin resistance are those being diagnosed with Type 2 diabetes.
Type 2 diabetes in children may go undiagnosed for a considerable period of time. Children may have minimal symptoms, if any at all, and the disease requires blood tests to diagnose.
A condition, known by metabolic syndrome, insulin resistance syndrome, syndrome X or dysmetabolic syndrome, is a group of metabolic and clinical effects of insulin resistance. Individuals diagnosed with metabolic syndrome are at increased risk of diabetes, cardiovascular disease and death. Unfortunately, these are increasingly being recognized in children and adolescents.
The National Cholesterol Education Program defines metabolic syndrome as having three of the following: a fasting plasma glucose greater than 110 mg/dL, or blood triglycerides greater than 150 mg/ dl, or blood HDL less than 40mg/dL in men or less than 50 mg/dL in women, or a blood pressure greater than 130/85 mmHg, and lastly a waist measurement greater than 40 inches in men or 36 inches in women. Unfortunately, the differentiating standards for children are less well defined.
The International Diabetes Federation published a definition for metabolic syndrome in children and adolescents. The definition is divided according to age groups: age 6 to 10 years; 10 to 16 years; and 16 and older.
Parents will find their children being treated aggressively for weight control, insulin resistance, cholesterol and blood pressure.
Obesity will be addressed initially via counseling, diet and exercise, but medication may be necessary to include. Metformin (Glucophage), as well as Sibutramine (Meridia), have been studied in a small number of overweight adolescents. Metformin is not generally used in children or adolescents unless Type 2 diabetes is diagnosed.
Prevention of Type 2 diabetes is the paramount goal of pediatricians, as once patients develop Type 2 diabetes, they will be at risk for complications the rest of their lives.
High cholesterol in children is addressed as in adults. Fat and cholesterol restrictions are recommended, but after six-12 months may quickly move on to bile-acid sequestrants -- generally poorly tolerated in young individuals -- and ultimately the statins.
Hypertension in children will be addressed initially without medication but if uncontrolled, will be initially addressed with an angiotensin-converting enzyme inhibitor, or an angiotensin receptor blocker, or a calcium channel blocker.
The aggressive treatment of metabolic syndrome is essential to prevent development of Type 2 diabetes and the morbidity and mortality associated with this disease.
(c) 2008 Daily Record, The Wooster, OH. Provided by ProQuest Information and Learning. All rights Reserved.
Source: Daily Record, The Wooster, OH
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