Childhood obesity rates are on the rise, and now pediatricians have come up with a list of guidelines for children struggling with weight-related diabetes. A mere decade ago, pediatricians never would have imagined a need for such guidelines, as children rarely suffered from weight-related diabetes.
While children have long been diagnosed with Type 1 diabetes — in which the body fails to produce enough insulin to process glucose in the blood — doctors are now seeing an ever-increasing number of children with Type 2 diabetes. In Type 2 diabetes, fat cells enlarge with weight gain, and thwart the body’s ability to break down sugars. In other words, Type 1 diabetes is not preventable. Type 2 is. Up to a third of diabetes cased in children these days are Type 2. Generally, Type 2 diabetes develops later in life, typically after age 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 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 American Academy of Pediatrics finally decided that there is now a need for clear, consistent advice on how to handle and treat this disease in kids. The first recommendation on the newly-released list: screen all obese children for diabetes.
Then, doctors need to figure out what type of diabetes they have, and plan a course of treatment from there.
The guidelines are geared toward kids ages 10 and 18, and are the first of their kind. They 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.
Children with Type 2 diabetes don’t necessarily need insulin, whereas children with Type 1 do. There is therefore a significant difference in how the two types are treated. A big part of the treatment plan for those with Type 2 diabetes is diet and exercise. One guideline states that “they should be encouraged to move: doctors should advise them to exercise at least an hour a day and limit screen time that’s not related to schoolwork to under two hours a day.”
Parents also should be advised that overweight and obese children should lose weight and exercise regularly, the guidelines state, in order to reduce their risk for the disease. Studies of such diet and physical activity changes in adults showed that many diabetics could reduce their dependence on medications, and people who are likely to develop the disease could lower their risk by 58% compared to those who didn’t change their eating and exercise habits. The same could be proven true with children.
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