Aggressive intervention recommended to prevent pediatric diabetes

Type 2 diabetes, once considered an adult disease, is increasingly causing health complications among American youth. A research review published in the Journal of Osteopathic Medicine suggests physicians should work to more aggressively prevent pediatric diabetes.

Because few pediatric Type 2 diabetes treatment options are available, prevention is unusually important. To improve health outcomes, the paper's authors recommend physicians conduct regular screenings of children and adolescents, adopt a high level of suspicion, and intervene early and often with families who have children at risk for prediabetes and T2 diabetes.

"Pediatric type 2 diabetes is more progressive and aggressive than adult-onset Type 2 diabetes," said lead author Jay H. Shubrook, DO, 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," said Dr. Shubrook.

Childhood obesity is a complex problem that extends beyond the health behaviors 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," said Dr. Shubrook. "Osteopathic principles and practice, which incorporate a patient's environmental, societal, and lifestyle factors into care, support this process."

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The Journal of Osteopathic Medicine, founded in 1901 and known for 119 years as The Journal of the American Osteopathic Association, is the premier scholarly, peer-reviewed publication of the osteopathic medical profession. JOM conducts peer review of academic research manuscripts from a wide variety of medical specialties, covering the full spectrum of clinical settings in which osteopathic physicians practice. All submissions are vetted by a distinguished group of Section Editors led by Editor-in-Chief Ross Zafonte, DO, and supported by a full Editorial Board.