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Childhood Diabetes Type 2

Pediatric Type 2 Diabetes Mellitus

Pediatric Type 2 Diabetes Mellitus

Practice Essentials Although type 2 diabetes is widely diagnosed in adults, its frequency has markedly increased in the pediatric age group since the end of the 20th century. Most pediatric patients with type 2 diabetes belong to minority communities. A simplified scheme for the etiology of type 2 diabetes mellitus is shown in the image below. Signs and symptoms Distinguishing between type 1 and type 2 diabetes at diagnosis is important. Typical characteristics of type 2 diabetes include the following: Strong family history of type 2 diabetes: Familial lifestyle risk factors leading to obesity may be present, as may a family history of cardiovascular disease or metabolic syndrome Physical findings may include the following: See Clinical Presentation for more detail. Diagnosis Testing for type 2 diabetes should be considered when a patient is overweight and has any 2 of the following [1] : Signs of insulin resistance or conditions associated with insulin resistance (eg, acanthosis nigricans, hypertension dyslipidemia, PCOS) Recommendations for screening are as follows: Glucose values may be interpreted as follows: Other laboratory results that usually suggest type 2 diabetes are as follows: Testing for albuminuria can be done by means of 1 of the following 3 methods: Fasting lipid profiles should be obtained after stable glycemia is achieved and every 2 years thereafter if normal. Optimal values for children with type 2 diabetes are as follows [3] : See Workup for more detail. Management The goal of therapy is to achieve and maintain euglycemia and near-normal hemoglobin A1c (HbA1c) levels (< 7%). More specifically, glycemic and nonglycemic goals may include the following [4] : Treatments for pediatric type 2 diabetes include the following: To protect these patients from Continue reading >>

Obesity And Type 2 Diabetes In Children: Epidemiology And Treatment

Obesity And Type 2 Diabetes In Children: Epidemiology And Treatment

Go to: Abstract The incidence of overweight and obesity among children has increased dramatically in recent decades, with about one-third of children in the U.S. currently being either overweight or obese. Being overweight in early childhood increases risk for later obesity. There is evidence for the efficacy of family-based behavioral treatment to control weight and improve health outcomes. Obesity-related health risks have been documented, including metabolic syndrome. There is also increasing incidence of type 2 diabetes (T2D) among youth in recent years, with obesity and family history of T2D generally present. Lower income and ethnic minority status are associated with both obesity and T2D in youth. Most youth with T2D do not achieve optimal glycemic control, and are at high risk for later health complications. Obesity and T2D represent significant public health issues with potentially great personal and societal cost. Research addressing the prevention of obesity and T2D among youth is urgently needed. Keywords: Children, Adolescents, Overweight, Obese, Type 2 Diabetes, Treatment, Prevention Go to: Introduction The purpose of this article is to review the epidemiology and treatment of obesity and type 2 diabetes (T2D) in children and adolescents, as well as consider other relevant factors such as etiology and behavioral and psychological correlates. In recent years, rates of pediatric obesity have increased dramatically, and T2D in youth has also been diagnosed more frequently and at younger ages than typically seen before historically. With the current generation of youth in the United States being significantly more overweight than previous generations, and the fact that T2D is increasingly apparent at younger ages, both of these conditions represent significant Continue reading >>

Type 2 Diabetes And Kids: The Growing Epidemic

Type 2 Diabetes And Kids: The Growing Epidemic

Before the obesity epidemic in the United States, type 2 diabetes was practically unheard of in people under 30. That explains the former name for the disease: adult-onset diabetes. Not long ago, almost all children with diabetes suffered from the type 1 form of the disease, which means their bodies couldn't produce enough insulin. And type 2 diabetes, in which the pancreas may produce normal insulin levels but cells become resistant to it, typically took decades to develop. But type 2 diabetes isn't just for adults anymore. The number of children and adolescents with the condition (most of whom are diagnosed in their early teens) has skyrocketed over the last 20 years and is still climbing, prompting experts to call it an epidemic. Because young children who are obese are more likely to become diabetic when they're older, experts are paying particular attention to how much -- or how little -- pre-adolescents eat and exercise. Disease researchers at the Centers for Disease Control and Prevention (CDC) made the prediction that one in three children born in the United States in 2000 will likely develop type 2 diabetes sometime in their lifetime unless they get more exercise and improve their diets. The prediction was especially serious for Latino children. Without changes in diet and exercise, their odds of developing diabetes during their lifetime were about 50-50. Type 2 is not usually as life-threatening or dramatic as type 1 at the time of diagnosis, but it does increase the likelihood that children may develop serious long-term complications in later life such as blindness, kidney disease, and heart disease. With proper medical treatment and a self-care program that incorporates exercise, glucose monitoring, and nutrition, however, your child can likely keep his or h Continue reading >>

Type 2 Diabetes In Children

Type 2 Diabetes In Children

Print Overview Type 2 diabetes in children is a chronic disease that affects the way your child's body processes sugar (glucose). It's important to manage your child's diabetes because its long-term consequences can be disabling or even life-threatening. Type 2 diabetes is more commonly associated with adults. In fact, it used to be called adult-onset diabetes. But type 2 diabetes in children is on the rise, fueled largely by the obesity epidemic. There's plenty you can do to help manage or prevent type 2 diabetes in children. Encourage your child to eat healthy foods, get plenty of physical activity and maintain a healthy weight. If diet and exercise aren't enough to control type 2 diabetes in children, oral medication or insulin treatment may be needed. Symptoms Type 2 diabetes in children may develop gradually. About 40 percent of children who have type 2 diabetes have no signs or symptoms and are diagnosed during routine physical exams. Other children might experience: Increased thirst and frequent urination. Excess sugar building up in your child's bloodstream pulls fluid from tissues. As a result your child might be thirsty — and drink and urinate more than usual. Weight loss. Without the energy that sugar supplies, muscle tissues and fat stores simply shrink. However, weight loss is less common in children with type 2 diabetes than in children with type 1 diabetes. Fatigue. Lack of sugar in your child's cells might make him or her tired and lethargic. Blurred vision. If your child's blood sugar is too high, fluid may be pulled from the lenses of your child's eyes. Your child might be unable to focus clearly. Slow-healing sores or frequent infections. Type 2 diabetes affects your child's ability to heal and resist infections. When to see a doctor See your child' Continue reading >>

Type 2 Diabetes In Children

Type 2 Diabetes In Children

There is an increase in the number of cases of type 2 diabetes in children and teens. The rise may be due to obesity and decreased physical activity among children. The risk for type 2 diabetes increases with age. What is type 2 diabetes? Type 2 diabetes is a metabolic disorder resulting from the body's inability to produce enough, or to properly use, insulin. It has previously been called non-insulin-dependent diabetes mellitus (NIDDM). Without enough insulin, the body cannot move blood sugar into the cells. It is a chronic disease with no known cure. What is prediabetes? In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with prediabetes develop type 2 diabetes within 10 years, states the National Institute of Diabetes and Digestive and Kidney Diseases. Prediabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes. What causes type 2 diabetes? The exact cause of type 2 diabetes is unknown. However, there is an inherited susceptibility which causes it to run in families. Although a person can inherit a tendency to develop type 2 diabetes, it usually takes another factor, such as obesity, to bring on the disease. Prevention or delay of onset of type 2 diabetes Type 2 diabetes may be prevented or delayed by following a program to eliminate or reduce risk factors, particularly losing weight and increasing exercise. Information gathered by the Diabetes Prevention Program, sponsored by the National Institutes of Health and the American Diabetes Association, continues to study this possibility. What are the symptoms of type 2 diabetes? The following are the most common symptoms for Continue reading >>

Rates Of New Diagnosed Cases Of Type 1 And Type 2 Diabetes On The Rise Among Children, Teens

Rates Of New Diagnosed Cases Of Type 1 And Type 2 Diabetes On The Rise Among Children, Teens

Fastest rise seen among racial/ethnic minority groups. Rates of new diagnosed cases of type 1 and type 2 diabetes are increasing among youth in the United States, according to a report, Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012 (link is external), published today in the New England Journal of Medicine. In the United States, 29.1 million people are living with diagnosed or undiagnosed diabetes, and about 208,000 people younger than 20 years are living with diagnosed diabetes. This study is the first ever to estimate trends in new diagnosed cases of type 1 and type 2 diabetes in youth (those under the age of 20), from the five major racial/ethnic groups in the U.S.: non-Hispanic whites, non-Hispanic blacks, Hispanics, Asian Americans/Pacific Islanders, and Native Americans. However, the Native American youth who participated in the SEARCH study are not representative of all Native American youth in the United States. Thus, these rates cannot be generalized to all Native American youth nationwide. The SEARCH for Diabetes in Youth study (link is external), funded by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), found that from 2002 to 2012, incidence, or the rate of new diagnosed cases of type 1 diabetes in youth increased by about 1.8 percent each year. During the same period, the rate of new diagnosed cases of type 2 diabetes increased even more quickly, at 4.8 percent. The study included 11,244 youth ages 0-19 with type 1 diabetes and 2,846 youth ages 10-19 with type 2. “Because of the early age of onset and longer diabetes duration, youth are at risk for developing diabetes related complications at a younger age. This profoundly lessens their quality of life, shortens their life expectanc Continue reading >>

Type 2 Diabetes Symptoms & Causes

Type 2 Diabetes Symptoms & Causes

Because our research informs our treatment, our diabetes team is known for our innovative treatments and science-driven approach. Boston Children's Hospital is home to the world’s most extensive pediatric hospital research enterprise, and we partner with elite health care and biotech organizations around the globe. But as specialists in family-centered care, our physicians never forget that your child is precious, and not just a patient. In dealing with your child’s diabetes, you probably want to know the basics about what diabetes is, and how type 2 diabetes differs from other forms of the disease. What are the major forms of diabetes? Diabetes (diabetes mellitus) is a lifelong condition that occurs when the body doesn’t make enough insulin, or when the body doesn’t respond properly to the insulin it makes. There are many forms of diabetes mellitus, several of which have undergone name changes as the disease has become better understood. type 2 diabetes: Formerly known as “adult onset” or “non-insulin dependent” diabetes, type 2 diabetes typically occurs in people who are overweight, physically inactive and over age 40, although more and more children are developing type 2 diabetes, possibly because of childhood obesity. Some children need insulin; others can control their diabetes with healthful eating and exercise, or oral medicines (hypoglycemic agents). type 1 diabetes: Formerly known as “juvenile” or “insulin-dependent” diabetes, type 1 diabetes is caused by the immune system’s failure to recognize the beta cells as belonging to the body, so it attacks and destroys them. This is why type 1 diabetes is considered an autoimmune disease. Children with type 1 diabetes must take insulin injections every day. maturity onset diabetes of youth (M Continue reading >>

In Teens, Diabetes Takes A More Dangerous Course

In Teens, Diabetes Takes A More Dangerous Course

THURSDAY, May 23, 2013 – A growing number of overweight teens are developing type 2 diabetes before they graduate from high school or learn how to drive, and new research paints an increasingly dismal picture for their future. The disease progresses more quickly in youth than adults, and children with type 2 diabetes rapidly develop signs of complications such as heart and kidney disease, according to a series of studies from the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) trial published today in a special issue of the journal Diabetes Care. These findings are especially concerning because the teens in the study had poor outcomes despite receiving optimal care and close monitoring from a team of diabetes experts. “Type 2 diabetes, when it occurs in youth, is a very, very, very rapidly progressing and serious disease — far worse than in the more typical 50-, 60-, or 70-year-old person who develops diabetes,” said Kenneth Copeland, MD, director of the children’s program at the Harold Hamm Diabetes Center at the University of Oklahoma and the national co-chair of the TODAY study. “It is extremely difficult to treat with any of the modalities we have available to us right now, and it progresses relentlessly towards complications regardless of the form of treatment that we offer them.” Compounding the problem is the fact that only two type 2 diabetes medications are approved for use in children. Physicians have limited options to help young people keep their blood sugar under control and minimize the risk for health problems down the road. About 3,700 people under age 20 are diagnosed with type 2 diabetes in the U.S. each year. While that figure is small compared to the incidence in adults, the number of children living with the dise Continue reading >>

Diabetes In Children And Teens: Signs And Symptoms

Diabetes In Children And Teens: Signs And Symptoms

With more than a third of diabetes cases in the United States occurring in people over the age of 65, diabetes is often referred to as an age-related condition. But around 208,000 children and adolescents are estimated to have diabetes, and this number is increasing. Type 1 diabetes is the most common form of the condition among children and adolescents. A 2009 report from the Centers for Disease Control and Prevention (CDC) revealed that type 1 diabetes prevalence stands at 1.93 in every 1,000 children and adolescents, while type 2 diabetes affects 0.24 in every 1,000. In 2014, Medical News Today reported that, based on a study published in JAMA, rates of both type 1 and type 2 diabetes have increased significantly among American children and teenagers. The study found that incidence of type 1 diabetes in children aged up to 9 years increased by 21 percent between 2001 and 2009, while incidence of type 2 diabetes among youths aged 10-19 years rose by 30.5 percent. The researchers note: "The increases in prevalence reported herein are important because such youth with diabetes will enter adulthood with several years of disease duration, difficulty in treatment, an increased risk of early complications and increased frequency of diabetes during reproductive years, which may further increase diabetes in the next generation." Contents of this article: Here are some key points about diabetes in children. More detail and supporting information is in the main article. Type 1 and 2 diabetes are both increasing in the youth of America Often, the symptoms of type 1 diabetes in children develop over just a few weeks If type 1 diabetes is not spotted, the child can develop diabetic ketoacidosis (DKA) What is diabetes in children? Type 1 diabetes in children, previously called juve Continue reading >>

How Can We Slow The Alarming Rise Of Type 2 Diabetes In Children?

How Can We Slow The Alarming Rise Of Type 2 Diabetes In Children?

Type 2 diabetes was once known as "adult onset" because it was so rare in kids. Not anymore. With one in five school-age children considered obese, the rate of Type 2 diabetes in young people is climbing. The newest study shows an almost 5 percent jump over a decade for those between the ages of 10 and 19. Dr. Tara Narula joined "CBS This Morning" to discuss what's behind the alarming rise, how the complications resulting from diabetes are happening earlier in life, and the importance of educating kids on the dangers of the disease. "This is not something we talked about 20 years ago and it is heartbreaking to think that now in this country there are about 20,000 children – children – who have Type 2 diabetes," Narula said. Narula said the biggest risk factor for developing the disease is obesity. "We have an obesity epidemic. In addition to that, look at the lifestyle we lead now. How many of our children are getting the recommended 60 minutes of exercise? How many are sitting in front of screens all day long eating fast and processed food?" In addition to the environmental factors that can precipitate diabetes, there's a family history component. "As a society we're all having more diabetes as adults. We can potentially pass that on to our children," Narula said. "And what happened prenatally – the more women have gestational diabetes, the more their kids are at risk for developing Type 2 diabetes." But there are still many questions about how to best treat the disease in children. "We do not have enough research to know how to appropriately treat children. We're basing a lot of it on adults and what we do for adults. But for example, we have a lot of medication that we can use for adults. For kids we can only use two so far that are considered safe and approved Continue reading >>

Type 2 Diabetes In Children

Type 2 Diabetes In Children

For decades, type 2 diabetes was considered an adults-only condition. In fact, type 2 diabetes was once called adult-onset diabetes. But what was once a disease mainly faced by adults is becoming more common in children. Type 2 diabetes is a chronic condition that affects how the body metabolizes sugar (glucose). Over 5,000 people under the age of 20 were diagnosed with type 2 diabetes between 2008 and 2009. Until 10 years ago, type 2 diabetes accounted for less than 3% of all newly diagnosed diabetes cases in adolescents; it now comprises 45% of all such cases. It’s more common in those aged 10-19 and in non-Caucasian populations, including African Americans, Native Americans, Asian/Pacific Islanders, and Hispanics. Being overweight is closely tied to the development of type 2 diabetes. Overweight children have an increased likelihood of insulin resistance. As the body struggles to regulate insulin, high blood sugar leads to a number of potentially serious health problems. In the past 30 years, obesity in children has doubled and obesity in adolescents has quadrupled, according to the CDC. Genetics may also play a role. For instance, the risk of type 2 diabetes increases if one parent or both parents has the condition. Symptoms of type 2 diabetes are not always easy to spot. In most cases, the disease develops gradually, making the symptoms hard to detect. Many people do not feel any symptoms. In other cases, children may not show any obvious signs. If you believe your child has diabetes, keep an eye out for these signs: Excessive fatigue: If your child seems extraordinarily tired or sleepy, their body may not have enough sugar to properly fuel their normal body functions. Excessive thirst: Children who have excessive thirst may have high blood sugar levels. Frequent Continue reading >>

Diabetes In Children And Teens

Diabetes In Children And Teens

Until recently, the common type of diabetes in children and teens was type 1. It was called juvenile diabetes. With Type 1 diabetes, the pancreas does not make insulin. Insulin is a hormone that helps glucose,or sugar, get into your cells to give them energy. Without insulin, too much sugar stays in the blood. Now younger people are also getting type 2 diabetes. Type 2 diabetes used to be called adult-onset diabetes. But now it is becoming more common in children and teens, due to more obesity. With Type 2 diabetes, the body does not make or use insulin well. Children have a higher risk of type 2 diabetes if they are overweight or have obesity, have a family history of diabetes, or are not active. Children who are African American, Hispanic, Native American/Alaska Native, Asian American, or Pacific Islander also have a higher risk. To lower the risk of type 2 diabetes in children Have them maintain a healthy weight Be sure they are physically active Have them eat smaller portions of healthy foods Limit time with the TV, computer, and video Children and teens with type 1 diabetes may need to take insulin. Type 2 diabetes may be controlled with diet and exercise. If not, patients will need to take oral diabetes medicines or insulin. A blood test called the A1C can check on how you are managing your diabetes. Continue reading >>

What Are The Signs And Symptoms Of Type 2 Diabetes?

What Are The Signs And Symptoms Of Type 2 Diabetes?

People with type 2 diabetes often appear symptom-free in the early stages. That's the reason that as many as 30% of people with type 2 diabetes are unaware of their disease. When symptoms do appear, they may come on gradually and be very subtle. At the time of diagnoses many people have some of the following symptoms: Feeling tired Being unusually thirsty Passing large volumes of urine, especially during the night Having frequent infections Having sores that don't heal Having blurred eyesight People with type 2 diabetes often share certain characteristics and related problems. The most common ones are: Weight A person with type 2 diabetes is usually overweight or obese. One way to determine obesity is to calculate a person's BMI (Body Mass Index), which is a number that is calculated based on a person's weight and height. If a child or teen's BMI is greater than the 85 th percentile for their gender and age (meaning that their score is within the top fifteen percent) they are considered overweight. If the BMI is greater than the 95th percentile (or within the top five percent) for gender and age, the child or teen is considered obese. In terms of their BMI score, an adult with a BMI higher than 25 is overweight and an adult with a BMI higher than 30 is obese. The Centers for Disease Control has BMI charts to help you. Lipids/Cholesterol Insulin resistance – which is associated with obesity and type 2 diabetes - tends to have a negative affect on a person's lipid (cholesterol) levels. If untreated over several years, high "bad" cholesterol and low "good" cholesterol increase the risk for cardiovascular (heart) problems. For a person less than 20 years of age, the desired fasting lipid levels are: LDL (bad) cholesterol should normally be less than 130 mg/dL. If someone Continue reading >>

Prevent Type 2 Diabetes In Kids

Prevent Type 2 Diabetes In Kids

There’s a growing type 2 diabetes problem in our young people. But parents can help turn the tide with healthy changes that are good for the whole family. 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 problem closely related to the increase in kids with type 2 diabetes, some as young as 10 years old. Weight Matters People who are overweight—especially if they have excess belly fat—are more likely to have insulin resistance, kids included. Insulin resistance is a major risk factor for type 2 diabetes. Insulin is a hormone made by the pancreas that acts like a key to let blood sugar into cells for use as energy. Because of heredity (traits inherited from family members) or lifestyle (eating too much and moving too little), cells can stop responding normally to insulin. That causes the pancreas to make more insulin to try to get cells to respond and take in blood sugar. As long as enough insulin is produced, blood sugar levels remain normal. This can go on for several years, but eventually the pancreas can’t keep up. Blood sugar starts to rise, first after meals and then all the time. Now the stage is set for type 2 diabetes. Insulin resistance usually doesn’t have any symptoms, though some kids develop patches of thickened, dark, velvety skin called acanthosis nigricans, usually in body creases and folds such as the back of the neck or armpits. They may also have other conditions related to insulin resistance, including: Activity Matters Being physically active lowers the risk for type 2 diabetes because it helps the body use insulin better, decreasing insulin resistance. Physical activity improves health in lots of other Continue reading >>

Type 2 Diabetes: What Is It?

Type 2 Diabetes: What Is It?

Diabetes is a disease that affects how the body uses glucose , the main type of sugar in the blood. Our bodies break down the foods we eat into glucose and other nutrients we need, which are then absorbed into the bloodstream from the gastrointestinal tract. The glucose level in the blood rises after a meal and triggers the pancreas to make the hormone insulin and release it into the bloodstream. But in people with diabetes, the body either can't make or can't respond to insulin properly. Insulin works like a key that opens the doors to cells and lets the glucose in. Without insulin, glucose can't get into the cells (the doors are "locked" and there is no key) and so it stays in the bloodstream. As a result, the level of sugar in the blood remains higher than normal. High blood sugar levels are a problem because they can cause a number of health problems. The two types of diabetes are type 1 and type 2. Both make blood sugar levels higher than normal but they do so in different ways. Type 1 diabetes happens when the immune system attacks and destroys the cells of the pancreas that produce insulin. Kids with type 1 diabetes need insulin to help keep their blood sugar levels in a normal range. Type 2 diabetes is different. A person with type 2 diabetes still produces insulin but the body doesn't respond to it normally. Glucose is less able to enter the cells and do its job of supplying energy (a problem called insulin resistance ). This raises the blood sugar level, so the pancreas works hard to make even more insulin. Eventually, this strain can make the pancreas unable to produce enough insulin to keep blood sugar levels normal. People with insulin resistance may or may not develop type 2 diabetes it all depends on whether the pancreas can make enough insulin to keep b Continue reading >>

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