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Pre Diabetes Children

Diagnosing Type 2 Diabetes In Children

Diagnosing Type 2 Diabetes In Children

Doctors at Hassenfeld Children’s Hospital at NYU Langone have extensive experience diagnosing type 2 diabetes in children. This chronic condition is characterized by excess blood sugar. After you eat, the body breaks down sugars and starches into glucose, the main source of energy for cells. When glucose enters the bloodstream, the pancreas releases a hormone called insulin, which signals the liver, muscles, and fat cells to remove the glucose from the blood and store it until the body needs energy. If the body becomes less responsive to the effects of insulin—a condition known as insulin resistance—the pancreas compensates and produces more insulin. With insulin resistance, the body has difficulty absorbing sugar from the bloodstream, leading to an increase in blood sugar levels, a condition known as prediabetes. Type 2 diabetes occurs when the body stops responding to the insulin signal and the pancreas can no longer make enough insulin to compensate for rising blood sugar levels. Causes and Risk Factors Once referred to as adult-onset diabetes, type 2 diabetes has become increasingly common during childhood and adolescence. This trend appears to be linked to an increase in obesity and sedentary habits among children and teens. Although the exact cause of insulin resistance is not completely understood, evidence suggests that being overweight plays an important role. This is because fat cells—especially those found in the abdomen—produce hormones and other substances that increase inflammation in the body, which can lead to insulin resistance. Being inactive, which can contribute to weight gain and lower muscle mass, may be another cause of insulin resistance. Girls with a hormone condition called polycystic ovary syndrome—which can cause facial hair and t Continue reading >>

Prediabetes

Prediabetes

Topic Overview What is prediabetes? Prediabetes is a warning sign that you are at risk for getting type 2 diabetes. It means that your blood sugar is higher than it should be, but not high enough to be diabetes. Prediabetes is also called impaired glucose tolerance or impaired fasting glucose. Most people who get type 2 diabetes have prediabetes first. What causes prediabetes? The food you eat turns into sugar, which your body uses for energy. Normally, an organ called the pancreas makes insulin, which allows the sugar in your blood to get into your body's cells. But when your body can't use insulin the right way, the sugar doesn't move into cells. It stays in your blood instead. This is called insulin resistance. The buildup of sugar in the blood causes prediabetes. People who are overweight, aren't physically active, and have a family history of diabetes are more likely to get prediabetes. Women who have had gestational diabetes are also more likely to get prediabetes. What are the symptoms? Most people with prediabetes don't have any symptoms. But if you have prediabetes, you need to watch for signs of diabetes, such as: Feeling very thirsty. Urinating more often than usual. Feeling very hungry. Having blurred vision. Losing weight without trying. How is prediabetes diagnosed? A blood test can tell if you have prediabetes. You have prediabetes if: The results of your hemoglobin A1c test are 5.7% to 6.4%. The results of your oral glucose tolerance test (OGTT) are 140 to 199 mg/dL (2 hours after the beginning of the test). How is it treated? The key to treating prediabetes and preventing type 2 diabetes is getting your blood sugar levels back to a normal range. You can do this by making some lifestyle changes. Watch your weight. If you are overweight, losing just a sma Continue reading >>

What Is Pre-diabetes?

What Is Pre-diabetes?

What Should I Do If I Have It? Are you one of the estimated 54 million people in this country who have pre-diabetes? If you have pre-diabetes, you are at high risk of developing type 2 diabetes and also are at increased risk of developing heart disease. Pre-diabetes is a condition in which blood glucose levels are higher than normal, but not high enough to be classified as full-blown diabetes. Those with pre-diabetes are at increased risk of developing type 2 diabetes within a decade unless they adopt a healthier lifestyle that includes weight loss and more physical activity. First, let's define what "pre-diabetes" is and is not. Diabetes is defined as having a fasting plasma blood glucose level of 126 mg/dl or greater on two separate occasions. If diabetes symptoms exist and you have a casual blood glucose taken at any time that is equal to or greater than 200 mg/dl, and a second test shows the same high blood glucose level, then you have diabetes. In general, people who have a fasting plasma blood glucose in the 100-125 mg/dl range are defined as having impaired fasting glucose. If your doctor gives you an oral glucose tolerance test, and at two-hours your blood glucose is 140-199 mg/dl, you have "impaired glucose tolerance". Either of these is medical terminology for what your doctor is probably referring to when he says you have "pre-diabetes." Be sure to ask your doctor what your exact blood sugar test results are when he tells you that you have "pre-diabetes." Some physicians are not as familiar as they should be with the new national guidelines for diagnosing diabetes. They may be telling you that you have pre-diabetes, when in fact you have actual diabetes. Among those who should be screened for pre-diabetes include overweight adults age 45 and older and those u Continue reading >>

Children And Diabetes

Children And Diabetes

Tweet Throughout the world, incidences of diabetes are on the rise, and consequently so is diabetes amongst children. Most children are affected by type 1 diabetes in childhood. However, the number of children and young adults affected by type 2 diabetes is beginning to rise, particularly in America. Approximately 90% of young people with diabetes suffer from type 1 and the number of patients who are children varies from place to place. A figure of 17 per 100,000 children developing diabetes each year has been reported. As metabolic syndrome, obesity and bad diets spread, so too have the first incidences of type 2 diabetes, previously incredibly rare. Further relevant pages Diabetes & pregnancy Juvenile diabetes Keeping your kids free from diabetes Teenage diabetes and blood glucose testing How is diabetes caused in children? The actual causes of the diabetic condition are little understood, in both children and adults. It is widely speculated that diabetes occurred when inherited genetic characteristics are triggered by environmental factors such as diet or exercise. Many type 1 diabetic children do not have diabetes in their families however, so the exact cause remains a mystery. Type 2 diabetes amongst children is usually caused by an extremely bad diet from a very young age, coupled with a sedentary lifestyle without exercise. What symptoms do children with diabetes exhibit? Like adults, a number of symptoms may give early warning that diabetes has developed. One or more of the following symptoms may be associated with diabetes: Thirst Tiredness Weight loss Frequent urination Amongst children, specific symptoms may include stomach aches, headaches and behavioural problems. Recurrent tummy pains and an unexplainable history of illness should be treated as possible he Continue reading >>

How To Prevent Prediabetes In Children

How To Prevent Prediabetes In Children

We make life and death decisions at the grocery store buying food for our family. It’s never too early to start our kids off on the right foot. See my video Heart Disease Starts in Childhood. And healthy doesn’t have to mean more expensive. Check out Eating Healthy on a Budget. For some tips on getting our kids to eat their vegetables, see my videos Tricks to Get Kids to Eat Healthier at School and Tricks to Get Kids to Eat Healthier at Home. Once one has prediabetes, there’s a way to prevent it from progressing further. See my previous video How to Prevent Prediabetes from Turning into Diabetes. If you haven’t yet, you can subscribe to my videos for free by clicking here. Continue reading >>

Study Finds 23 Percent Of Teens Have Prediabetes Or Diabetes

Study Finds 23 Percent Of Teens Have Prediabetes Or Diabetes

Cardiovascular disease is the leading cause of death among adults in the U.S. Although heart attacks and stroke usually do not occur until adulthood, cardiovascular risk factors are often present in childhood. A study in the June 2012 issue of Pediatrics (published online May 21) examines how common these risk factors are in adolescents compared to a decade ago. The study, “Prevalence of Cardiovascular Disease Risk Factors Among U.S. Adolescents, 1999-2008,” examined data from nearly 3,400 adolescents aged 12 to 19 from the NHANES survey.In the study, 50 percent of the overweight teens and 60 percent of the obese teens had one or more cardiovascular risk factors in addition to their weight status, and 37 percent of normal-weight adolescents had at least one risk factor during the 1999-2008 period of study. The prevalence of prehypertension/hypertension and borderline-high or high low-density lipoprotein cholesterol did not change between 1999 and 2008. However, the prevalence of prediabetes/diabetes increased significantly, from 9 percent to 23 percent. The prevalence of obesity did not increase during the study period, and study authors suggest this may explain why other cardiovascular risk factors like borderline-high and high low-density lipoprotein cholesterol and prehypertension/hypertension also plateaued. The most common combination of CVD risk factors among overweight and obese children was prehypertension/hypertension and borderline-high or high low-density lipoprotein cholesterol (26 percent). Study authors conclude the results indicate that U.S. adolescents carry a substantial burden of cardiovascular risk factors, especially teens who are overweight or obese, and that adolescence represents a window of opportunity to assess these risk factors and promote Continue reading >>

Vanderbilt Pre-diabetes Clinic Tackles Type 2 Diabetes In Children

Vanderbilt Pre-diabetes Clinic Tackles Type 2 Diabetes In Children

by Meredith Jackson In Middle Tennessee, where roughly one-third of children are overweight or obese, the risk of developing pediatric type 2 diabetes is high and the consequences can be serious. The risk of death is 36 percent higher in patients diagnosed with type 2 diabetes in their late teens and 20s than it is among adults diagnosed in their 30s. “Type 2 diabetes is much more aggressive in children and we don’t understand why,” said Ashley Shoemaker, M.D., MSCI, assistant professor of Pediatrics in the Division of Endocrinology and Diabetes at Vanderbilt. Shoemaker and her colleagues direct the Vanderbilt Pre-Diabetes Clinic, which aims to prevent or manage type 2 diabetes in young people. Her colleagues include Cassie Brady, M.D., assistant professor of Pediatrics, Tamasyn Nelson, D.O., assistant professor of Pediatrics, and nurse practitioner Sharon Karp, MSN, Ph.D., assistant professor of Nursing. They are particularly interested in borderline cases — patients who have some potential signs or symptoms of early type 2 diabetes but who don’t fit the diagnostic criteria of patients served by other clinics. The clinic’s collaborative environment provides patients with access to lab tests, endocrinologists, weight management physicians and dietitians — all in one place. “We try to figure out which kids need medical intervention right now and which are at high risk but can really focus on lifestyle and weight management,” Shoemaker said. The clinic also is the only site in Tennessee where patients can enroll in clinical trials of potential new treatments for pediatric type 2 diabetes. “We want to catch (patients) early before they’ve already lost the ability to make insulin,” Shoemaker said. “We get them the medical evaluation that the famili Continue reading >>

Prediabetes In Children. What To Do?

Prediabetes In Children. What To Do?

Did you know that Type 2 diabetes is more aggressive in youth than in adults? Kids and teenagers start suffering from serious complications from the disease just a few years after diagnosis, new research1 has found. Prediabetes in children That’s why it’s so important to set kids up with healthy lifestyle habits, particularly those who are overweight or have prediabetes, so that full-blown Type 2 diabetes can hopefully be prevented from ever happening. The new research, coordinated by the American Diabetes Association, recruited 699 children nationwide who were diagnosed with Type 2 diabetes between the ages of 10 and 17 and had had the disease on average eight months. All the children were overweight or obese. In the study, which resulted in a series of articles published in the June 2013 issue of Diabetes Care, the children received one of three treatments: The drug metformin Metformin plus intensive lifestyle changes Metformin plus another drug, rosiglitazone None of the interventions appeared to do much good. After four years, the scientists reported that: Rates of high blood pressure, or hypertension, among the children had tripled. Initial signs of kidney disease, or microalbuminuria, had almost tripled. Destruction of the cells in the pancreas that produce insulin (beta cells) had occurred at a rate nearly four times higher than in adults. The percentage of children needing cholesterol-lowering medications had more than doubled. The scientists were surprised and dismayed, thinking they were on top of treatments for the children, yet the disease still progressed at an alarming rate. Their conclusions: Preventing Type 2 diabetes by fighting obesity and prediabetes in children is essential. “The challenges in effectively treating Type 2 diabetes in youth highl Continue reading >>

Diagnosing Diabetes And Prediabetes In Children

Diagnosing Diabetes And Prediabetes In Children

Steve Freed, R.Ph., CDE Publisher of www.diabetesincontrol.com Diabetes is one of the most common chronic diseases in children and adolescents: about 151,000 people below the age of 20 years have diabetes.1 When diabetes strikes during childhood, it is routinely assumed to be type 1, or juvenile-onset diabetes. However, in the last two decades, type 2 diabetes (formerly known as adult-onset diabetes) has been reported among U.S. children and adolescents with increasing frequency. Facts: The CDC has stated that 1 in 3 children will get diabetes and if you are African, Hispanic, or Native American, every other child will get type 2 diabetes.1 The epidemics of obesity and the low level of physical activity among young people, as well as exposure to diabetes in utero, may be major contributors to the increase in type 2 diabetes during childhood and adolescence. Children and adolescents diagnosed with type 2 diabetes are generally between 10 and 19 years old, obese, have a strong family history for type 2 diabetes, and have insulin resistance. Generally, children and adolescents with type 2 diabetes have poor glycemic control (A1c = 10% - 12%). If an adult gets diabetes at the age of 40 or 50, becomes educated about the disease, maintains a healthy diet, and increases their physical activity, they can reduce their risk of complications. However, if a child gets diabetes at the age of 10 or 20, will they maintain a healthy diet and increase their physical activity for the next 40-60 years? There are a total of 25.8 million children and adults in the United States with diabetes -- 8.3% of the population. Approximately 1.9 million new cases of diabetes were diagnosed in 20101. How to find children with type 2 diabetes? Prior to 2010 the only way to diagnose diabetes was to do a Continue reading >>

Utility Of Hemoglobin A1c For Diagnosing Prediabetes And Diabetes In Obese Children And Adolescents

Utility Of Hemoglobin A1c For Diagnosing Prediabetes And Diabetes In Obese Children And Adolescents

OBJECTIVE Hemoglobin A1c (A1C) has emerged as a recommended diagnostic tool for identifying diabetes and subjects at risk for the disease. This recommendation is based on data in adults showing the relationship between A1C with future development of diabetes and microvascular complications. However, studies in the pediatric population are lacking. RESEARCH DESIGN AND METHODS We studied a multiethnic cohort of 1,156 obese children and adolescents without a diagnosis of diabetes (male, 40%/female, 60%). All subjects underwent an oral glucose tolerance test (OGTT) and A1C measurement. These tests were repeated after a follow-up time of ∼2 years in 218 subjects. RESULTS At baseline, subjects were stratified according to A1C categories: 77% with normal glucose tolerance (A1C <5.7%), 21% at risk for diabetes (A1C 5.7–6.4%), and 1% with diabetes (A1C >6.5%). In the at risk for diabetes category, 47% were classified with prediabetes or diabetes, and in the diabetes category, 62% were classified with type 2 diabetes by the OGTT. The area under the curve receiver operating characteristic for A1C was 0.81 (95% CI 0.70–0.92). The threshold for identifying type 2 diabetes was 5.8%, with 78% specificity and 68% sensitivity. In the subgroup with repeated measures, a multivariate analysis showed that the strongest predictors of 2-h glucose at follow-up were baseline A1C and 2-h glucose, independently of age, ethnicity, sex, fasting glucose, and follow-up time. CONCLUSIONS The American Diabetes Association suggested that an A1C of 6.5% underestimates the prevalence of prediabetes and diabetes in obese children and adolescents. Given the low sensitivity and specificity, the use of A1C by itself represents a poor diagnostic tool for prediabetes and type 2 diabetes in obese children Continue reading >>

Prediabetes

Prediabetes

Overview What is prediabetes? Before people develop type 2 diabetes, they usually have prediabetes. In people who have prediabetes, blood sugar levels are higher than normal but not high enough to say they have diabetes. Normal “fasting blood sugar” is between 70 and 99 mg per dL. Fasting blood sugar is your blood sugar level you before you have something to eat in the morning. Fasting blood sugar between 100 and 125 mg per dL suggests prediabetes. Fasting blood sugar higher than 126 mg per dL is considered diabetes. People who have prediabetes have a high risk of eventually developing diabetes. Causes Who is at risk? You are at risk for prediabetes if any of the following are true: You are overweight or obese. You have a parent, brother or sister who has diabetes. You had diabetes during pregnancy (called gestational diabetes) or had a baby who weighed more than 9 pounds at birth. You belong to any of the following ethnic groups: African American, Native American, Latin American or Asian/Pacific Islander. Your high-density lipoprotein (HDL) cholesterol level (“good” cholesterol) is less than 40 mg per dL (for men) or less than 50 mg per dl (for women), or your triglyceride level is higher than 250 mg per dL. Prevention If I have prediabetes, can I avoid developing diabetes? You can lower your risk of developing diabetes by making changes in your lifestyle. If you are overweight, losing weight can help. Losing weight also helps lower your blood pressure and cholesterol levels. Exercise is also important. Your exercise routine should include 30 minutes of moderate physical activity (such as brisk walking or swimming) at least 5 times a week. Ask your doctor what exercise level is safe for you. Follow a healthy diet. Eat foods such as vegetables, fruits, whole gra Continue reading >>

Prediabetes

Prediabetes

Prediabetes means you have blood glucose, or blood sugar, levels that are higher than normal but not high enough to be called diabetes. Glucose comes from the foods you eat. Too much glucose in your blood can damage your body over time. If you have prediabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. Most people with prediabetes don't have any symptoms. Your doctor can use an A1C test or another blood test to find out if your blood glucose levels are higher than normal. If you are 45 years old or older, your doctor may recommend that you be tested for prediabetes, especially if you are overweight. Losing weight - at least 5 to 10 percent of your starting weight - can prevent or delay diabetes or even reverse prediabetes. That's 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting down on the amount of calories and fat you eat and being physically active at least 30 minutes a day. Being physically active makes your body's insulin work better. Your doctor may also prescribe medicine to help control the amount of glucose in your blood. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Continue reading >>

Metformin Use In Children And Adolescents With Prediabetes

Metformin Use In Children And Adolescents With Prediabetes

With the increasing incidence of childhood obesity, clinicians need to understand its comorbidities and their management. The American Diabetes Association recommends pediatricians screen high-risk overweight and obese children. Identifying and treating prediabetic children and adolescents can help to reduce the burden of type 2 diabetes. Lifestyle interventions are pivotal. Metformin is the only oral medication approved for diabetes treatment in children. It has been studied in clinical trials in nondiabetic children and has been shown to have beneficial effects on body weight. Effects on diabetes prevention have not been studied and long-term data are limited in the pediatric population. Continue reading >>

Prediabetes

Prediabetes

Print Overview Prediabetes means that your blood sugar level is higher than normal but not yet high enough to be type 2 diabetes. Without lifestyle changes, people with prediabetes are very likely to progress to type 2 diabetes. If you have prediabetes, the long-term damage of diabetes — especially to your heart, blood vessels and kidneys — may already be starting. There's good news, however. Progression from prediabetes to type 2 diabetes isn't inevitable. Eating healthy foods, incorporating physical activity in your daily routine and maintaining a healthy weight can help bring your blood sugar level back to normal. Prediabetes affects adults and children. The same lifestyle changes that can help prevent progression to diabetes in adults might also help bring children's blood sugar levels back to normal. Symptoms Prediabetes generally has no signs or symptoms. One possible sign that you may be at risk of type 2 diabetes is darkened skin on certain parts of the body. Affected areas can include the neck, armpits, elbows, knees and knuckles. Classic signs and symptoms that suggest you've moved from prediabetes to type 2 diabetes include: Increased thirst Frequent urination Fatigue Blurred vision When to see a doctor See your doctor if you're concerned about diabetes or if you notice any type 2 diabetes signs or symptoms. Ask your doctor about blood glucose screening if you have any risk factors for prediabetes. Causes The exact cause of prediabetes is unknown. But family history and genetics appear to play an important role. Inactivity and excess fat — especially abdominal fat — also seem to be important factors. What is clear is that people with prediabetes don't process sugar (glucose) properly anymore. As a result, sugar accumulates in the bloodstream instead o Continue reading >>

Prediabetes In Children: Natural History, Diagnosis, And Preventive Strategies.

Prediabetes In Children: Natural History, Diagnosis, And Preventive Strategies.

Abstract The clinical manifestation of type 1 diabetes mellitus is preceded by an asymptomatic prodromal period called prediabetes or preclinical diabetes. It may last from a few months to several years, during which the autoimmune destruction of the insulin-producing beta-cells in the pancreas progresses. The genes on the human leukocyte antigen (HLA) and insulin gene region are major genetic determinants for genetic disease susceptibility, while dietary compounds and viral infections are the most likely environmental factors contributing to the etiopathogenesis. T cells are thought to be the effector cells for the beta-cell destruction, and glutamic acid decarboxylase, insulinoma-associated protein 2 and insulin represent the three major autoantigens. Autoantibodies are early detectable markers of an ongoing disease process and are used to diagnose prediabetes. Among first-degree relatives of patients with type 1 diabetes, the risk for clinical disease can be graded from <5% in those with one or no antibodies to >90% in individuals who carry the HLA-DQB1*02/0302 risk genotype and are positive for multiple autoantibodies. beta-Cell function may also be tested in autoantibody-positive individuals and low first-phase insulin response is highly predictive for rapid progression to the clinical disease. However, dynamic course and individual variation of the disease process complicates the disease prediction, and it is not known whether all individuals with signs of prediabetes will inevitably progress to clinical type 1 diabetes. Until clinically applicable prevention for the condition exists, the screening for the risk markers of type 1 diabetes should actively be undertaken only in the context of research projects. Several major national and international multicenter stu Continue reading >>

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