When you think about type 2 diabetes what comes to your mind? Until recently, young children and teens almost never got type 2 diabetes, which is why it used to be called adult-onset diabetes. Now, about one-third of American youth are overweight, a challenge that is closely related to the increase in kids with type 2 diabetes.
Type 2 diabetes in our pediatric population is rising in all cultures. It has markedly been seen in Hispanic, Pacific Islanders, and African American populations, but we are now seeing an increase in obese Caucasian children. Children who get type 2 diabetes are usually diagnosed in their early teens. The hormones present during puberty makes it harder for the body to use insulin. This is especially true for girls, who are more likely than boys to develop type 2 diabetes. Some other risk factors for developing type 2 diabetes in children is obesity, family history, and being born to a mother who had gestational diabetes. Approximately 40 percent of children who present with type 2 diabetes are asymptomatic and a small percentage can present with diabetic ketoacidosis.
Until recently, there have not been any real standards or guidelines for this specific population. Most of the education has been like adult type 2 diabetes. The treatment options are reduced from the traditional list of medication treatments in adults, because the medications have not been studied in the pediatric population, so therefore are not FDA approved. Current treatment includes, metformin, liraglutide, and insulin. More studies are being done and hopefully soon we will have more medications approved for the treatment in children. Treatment includes the family and the need for lifestyle changes, glucose monitoring, and diabetes education will affect the entire family. The child needs to know that they are not alone. That’s an important reason to help children take charge of their health while they’re young. Type 2 diabetes is increasing at an alarming rate in our children. If we do not attempt to combat this, we will see younger adults with co-morbidities and diseases that at one time was only seen later in life.
Tammi Grumski, CRNP, BC, CDCES