Navigation Links
First-Ever Guidelines Issued for Treating Type 2 Diabetes in Kids

By Serena Gordon
HealthDay Reporter

MONDAY, Jan. 28 (HealthDay News) -- For the first time ever, the American Academy of Pediatrics has issued guidelines for the management of type 2 diabetes in children and teenagers aged 10 to 18.

Until recently, pediatricians have mostly had to deal with type 1 diabetes, which has a different cause and usually a different management than type 2 diabetes. But, today, due largely to the rise in childhood obesity, as many as one in three children diagnosed with diabetes has type 2.

"Pediatricians and pediatric endocrinologists are used to dealing with type 1 diabetes. Most have had no formal training in the care of children with type 2," said one of the authors of the new guidelines, Dr. Janet Silverstein, division chief of pediatric endocrinology at the University of Florida, in Gainesville.

"The major reason for the guidelines is that there's been an increase in overweight and obesity in children and adolescents, with more type 2 diabetes in that population, making it important for general pediatricians, as well as endocrinologists to have structured guidelines to follow," she said.

For example, it can be very difficult to distinguish immediately whether or not a child has type 1 or type 2 diabetes, especially if a child is overweight. The only way to tell for sure is a test for islet antibodies. Because type 1 diabetes is an autoimmune disease, a child or teen with type 1 will have islet antibodies that destroy the insulin-producing cells in the pancreas. But, it can take weeks to get the results of these tests, according to Silverstein.

Weight doesn't play a role in the development of type 1 diabetes, but it's possible that someone with type 1 could be overweight, making an immediate diagnosis of the type of diabetes very hard. If someone with type 1 diabetes is mistakenly diagnosed with type 2 diabetes, and given oral medications -- such as metformin -- instead of the insulin they must have, they can get very sick, very quickly.

That's why the first new guideline is to start a child or teen on insulin if it's at all unclear whether a child has type 1 or type 2 diabetes. The guideline further recommends that they continue using insulin until the diabetes type can be definitively determined.

Other key guidelines include the following:

  • Once a child or teen has been diagnosed with type 2 diabetes, prescribe metformin and lifestyle changes, including nutrition and physical activity.
  • Monitor hemoglobin A1c (HbA1c) levels every three months. HbA1c provides a measure of the past two to three months of blood sugar levels. If treatment goals aren't being met, the physician should make appropriate changes to the treatment regimen.
  • Home monitoring of blood glucose is appropriate for those using insulin, anyone changing their treatment regimen, those who aren't meeting their treatment goals and during times of illness.
  • Physicians should incorporate the Academy of Nutrition and Dietetics' Pediatric Weight Management Evidence-Based Nutrition Practice Guideline in nutrition counseling of children with type 2 diabetes.
  • Children with type 2 diabetes should be encouraged to exercise at least 60 minutes a day and to limit their nonacademic "screen time" (video games, television) to less than two hours a day.

"There's a need for type 2 guidelines in the pediatric population, and I think the new guidelines are good. But, there are a lot of unanswered questions," said Dr. Rubina Heptulla, chief of the division of pediatric endocrinology and diabetes at Children's Hospital at Montefiore in New York City.

"There's really only one large study on type 2 diabetes and children. These guidelines are a first step, and they highlight the critical need for more research," Heptulla said. For her part, Silverstein agreed that more well-designed research is needed.

The U.S. Centers for Disease Control and Prevention estimates that about 3,600 children are being diagnosed with type 2 diabetes every year, so pediatricians need to be aware that they may begin seeing children with type 2 in their practices.

Silverstein said that pediatricians should monitor HbA1C levels in overweight children, because it's much easier to prevent the disease than to treat it after it has occurred.

Type 1 diabetes tends to cause excessive thirst and frequent urination, but Silverstein said these symptoms aren't always present or as evident in children with type 2. If children have urethritis (inflammation of the tube that drains the bladder) or yeast infections in girls, doctors should consider testing their blood sugar levels.

The new guidelines were published online Jan. 28 and in the February print issue of Pediatrics.

More information

Learn more about preventing type 2 diabetes from the U.S. National Diabetes Education Program.

SOURCES: Janet Silverstein, M.D., division chief, pediatric endocrinology, University of Florida, Gainesville, Fla.; Rubina Heptulla, M.D., chief, division of pediatric endocrinology and diabetes, Children's Hospital at Montefiore, New York City; February 2013, Pediatrics

Copyright©2012 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Clinical trials for first-ever human hookworm vaccine advance
2. Massage Industry Heavyweights Team Up for First-Ever Massage Documentary
3. First-ever Allen Brain Atlas Hackathon unleashes big data API to push neuroscience forward
4. Lawson researcher receives 1 of first-ever Pfizer Psychiatry Research Awards
5. First guidelines for brain amyloid imaging in Alzheimers released
6. ISHLT issues new guidelines for care of mechanical circulatory support device patients
7. Younger Women Start to Follow Pap Test Guidelines: CDC
8. New Diabetes Guidelines May Lower Patient Medical Bills
9. New Guidelines Seek to Streamline Care for Worst Heart Attacks
10. Rural dwellers less likely to follow cancer screening guidelines
11. New IDSA guidelines aim to reduce death, disability, and cost of prosthetic joint infections
Post Your Comments:
Related Image:
First-Ever Guidelines Issued for Treating Type 2 Diabetes in Kids
(Date:12/1/2015)... ... December 01, 2015 , ... SAN FRANCISCO, Calif. ... that the organization has awarded Education and Developmental Therapies (EDT), an Applied Behavior ... award celebrates exceptional special needs providers that excel in synthesizing the areas of ...
(Date:12/1/2015)... ... 01, 2015 , ... Lutronic, a leading innovator of aesthetic and medical laser ... devices for sale in the United States. Clarity is a Superior Dual Wavelength ... lasers, into a single platform that is easy to own and operate. , ...
(Date:12/1/2015)... (PRWEB) , ... December 01, 2015 , ... XTC ... selected 10 semi-finalists to head to Las Vegas for CES 2016, the world’s largest ... CEO of Consumer Technology Association Gary Shapiro, Founding Partner of Pacific Investments Veronica Serra, ...
(Date:12/1/2015)... ... ... Nurotron Biotechnology Co., Ltd., maker of cochlear implant systems, has won a ... will be from the China Disabled Persons’ Federation, a central government association, for nearly ... children and adults suffering from severe and profound hearing loss . The company ...
(Date:12/1/2015)... , ... December 01, 2015 , ... ... Center Enterprise Authorized Technology Provider (ATP) status from Cisco. This designation recognizes Tympani ... support Cisco Unified Contact Center solutions targeted to the high-end enterprise contact center ...
Breaking Medicine News(10 mins):
(Date:12/1/2015)... India , December 1, 2015 ... and segments the concerned market with analysis and forecast ... orthobiologics report defines and segments the concerned market ... According to the Market Research Report "North American Orthobiologics ... Growth Factors & Spinal Stimulation, Stem Cell Therapy, Viscosupplementation), ...
(Date:12/1/2015)... and UPPSALA, Sweden , December 1, 2015 ... by the International Breast Cancer Study Group (IBCSG, ... Brussels ) to be part of a state ... promising new cancer drug.  --> ... advanced breast cancer being treated with anti-hormonal therapy in combination ...
(Date:12/1/2015)... , December 1, 2015 ... the addition of the  "2016 Shigella ... Innovative Technologies, Competitive Strategies, Emerging Opportunities--US, ... Japan"  report to their offering. ... the addition of the  "2016 Shigella ...
Breaking Medicine Technology: