Type 2 diabetes used to be an “adults only” condition, but not anymore. The prevalence of childhood obesity is changing the way doctors think about the disease.
For the first time a set of guidelines is being created to help kids 10 to 18 years old manage their type 2 diabetes. A two-pronged approach of medication and lifestyle changes is suggested to treat the disease at the initial diagnosis.
Why new guidelines are needed
Laurie Minarich-Tsilianidis, MD, who treats pediatric diabetic patients at Cleveland Clinic Children’s Hospital, says trying to talk kids diagnosed with type 2 diabetes into lifestyle changes isn’t effective by itself.
The prevalence of childhood obesity
is changing the way
doctors think about
type 2 diabetes.
“We found that recommending lifestyle modifications, which may be an appropriate initial approach in adults, has a success rate of less than 10 percent in children,” she says. “These guidelines tell us when it’s appropriate to choose what medications to use and, of course, recommending lifestyle changes at the same time.”
What the guidelines recommend
The guidelines were created by the American Diabetes Association along with other pediatric, endocrinological and nutritional groups. Among the recommendations:
- Treat children with insulin at the time of diagnosis if they have high blood glucose levels (for example, above 250), are hyperglycemic or if it’s unclear whether they have type 1 or 2 diabetes
- Treat children in all other cases with metformin — a first-line oral medication therapy that controls blood glucose levels for those able to produce some insulin
- Make lifestyle modifications with dietary changes and increased physical activity
“This is a serious disease that does require lifestyle changes, but also medication,” says Dr. Minarich-Tsilianidis. “If we attack it aggressively, perhaps one day kids can come off medications like adults hope to do.”