As many as 45 percent of new onset pediatric diabetes cases in the United States are type 2. This is partially due to the growing population of obese children and adolescents.
Type 2 diabetes affects more than 22 million adults in the United States. It used to be primarily diagnosed in people older than 40, but it now affects an alarming number of children.
Over the past 20 years, the prevalence of childhood and adolescent obesity has doubled, according to the American Academy of Pediatrics Committee, putting children at risk of developing type 2 diabetes. At diagnosis, 85 percent of these children are obese.
Obesity and a lack of physical activity, as well as exposure to diabetes in utero, are thought to be major contributors to the increase in type 2 diabetes during childhood and adolescence. Generally, the diagnosis applies to those between 10 and 19 years of age with insulin resistance and a strong family history of type 2 diabetes.
The age of development is connected to changes in puberty that affect hormone levels. Doctors often diagnose children exhibiting symptoms like obesity, glucose in the urine or excessive thirst.
The Centers for Disease Control and Prevention’s Division of Diabetes Translation has been conducting workshops to raise physician awareness about the disease, determine the magnitude of the problem and assess and improve the quality of care among children and adolescents with type 2 diabetes.
In about 10 percent of cases, lifestyle intervention for those diagnosed with diabetes early may be enough. Everyone else will need either insulin, medication or both to control their blood sugar.
The Food and Drug Administration (FDA) has approved certain insulin products for children and one oral medication, metformin. Metformin increases the body’s sensitivity to insulin and decreases the amount of glucose produced by the liver. It can also promote weight loss.
While many adults with type 2 diabetes may be taking a thiazolidinedione such as Actos, this class of drugs has not been studied for pediatric use.
Adults and children should be aware of the risks, however. Actos, which is the most popular diabetes drug worldwide, has been linked to vision problems, fractures and heart failure. The Food and Drug Administration (FDA) has placed a black-box warning on Actos, listing restrictions for people with heart conditions.
Actos has also been repeatedly linked to bladder cancer, including by a recent study that showed an 80 percent increase in the risk. Thousands of Actos lawsuits have been filed by patients who have suffered.
Before thiazolidinediones or other type 2 diabetes medications are prescribed to children, more studies are necessary.
A child’s ability to take on medical regimens, exercise plans and diet changes is contingent upon supportive parents and an understanding of the diagnosis.
The American Diabetes Association plans to develop educational strategies for teaching children about managing type 2 diabetes. Children may blame themselves if their condition worsens, but should know that the disease is progressive, meaning it will worsen with time. It is also important that they and their parents understand the risks associated with popular medications like
Actos side effects and with type 2 diabetes in general.
Alanna Ritchie is a writer for
Drugwatch.com. An English major, she is an accomplished technical and creative writer.
