| Abstract: |
This article reports on the current epidemic of type 2 diabetes in youth in the United States. The author estimates that between 15 and 20 percent of children and teens newly diagnosed with diabetes have type 2. The incidence of type 2 diabetes is particularly high within some racial and ethnic groups, including African Americans, Latinos, Native Americans, and Asians. An explosion of type 2 diabetes in adults and children appears to be developing in many countries where obesity, decreased physical activity, and increased consumption of high calorie, high fat foods are common. People with type 2 diabetes generally make quite a bit of insulin initially, but their cells are resistant to it, so they need more insulin than normal to use glucose for energy. Eventually the pancreas loses the ability to compensate with this higher level of insulin, so blood glucose levels rise. The author reviews the risk factors for diabetes, diagnostic approaches, and treatment options. Treatment is usually based on the child's condition at diagnosis. If the child is not sick at diagnosis, diet and exercise therapy should be initiated. However, lifestyle measures are often not enough to control blood glucose levels; eventually diabetes drugs may need to be added. Metformin (Glucophage) is approved for use in children ages 10 to 16 and is recommended as the first oral agent to be used in children. Self management education is a crucial part of any treatment regimen for a young person with diabetes. The author concludes with a list of screening recommendations and preventive strategies. One sidebar lists symptoms or signs that indicate a call to the health care provider is necessary. |