Physicians should work to more aggressively prevent paediatric diabetes, with physicians conducting regular screenings of children and adolescents, adopting a high level of suspicion, and intervening early and often with families who have children at risk for prediabetes and T2 diabetes – according to a research review, ‘Treatment options and current guidelines of care for paediatric type 2 diabetes patients: a narrative review’, published in the Journal of Osteopathic Medicine.
"Paediatric type 2 diabetes is more progressive and aggressive than adult-onset Type 2 diabetes," said lead author, Dr Jay H Shubrook, professor and diabetologist at Touro University California College of Osteopathic Medicine. "Kids need our help, and we're not sounding the alarm loud enough."
A young person's metabolism is different than that of an adult. The liver does not clear insulin at the same rate, and youths experience a more rapid decline in β-cell function, meaning they lose the ability to produce enough insulin more quickly than adults.
For young people who struggle with their weight, diabetes is a significant risk. Excessive weight can lead to insulin resistance, a turning point for the disease. The National Health and Nutrition Examination Survey, a national study that published in 2018 and again in 2020, found that the rate of obesity in youth was 18.5% and that prediabetes was found in 18% of adolescents.
"That the rates of youth obesity and prediabetes are nearly the same is not a coincidence," added Shubrook.
Childhood obesity is a complex problem that extends beyond the health behaviours of a child. The American Diabetes Association recommends considering food insecurity, housing instability, and potential financial limitations when working with families to create a plan to manage the disease. Stress, isolation, depression, anxiety, substance abuse, and eating disorders should be screened for during the evaluation and treatment process.
"The best chance at slowing the youth diabetes epidemic is for physicians to identify at-risk youths and provide early interventions that emphasize family-based preventive lifestyle changes," explained Shubrook. "Osteopathic principles and practice, which incorporate a patient's environmental, societal, and lifestyle factors into care, support this process."
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