Children and Type 2 Diabetes

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Type 2 diabetes used to be known as an obese adult disease. Today, the number of children who are being diagnosed with type 2 diabetes has sky-rocketed, and will increase four-fold by 2050. Studies have found that children who are obese have 40% lower insulin-stimulated glucose metabolism compared to non-obese children.  Children with type 2 diabetes typically are diagnosed over the age of 10. They are most likely obese or extremely obese and have glucose in their urine without ketones. Puberty can play a role in the development of type 2 diabetes due to the secretion of growth hormone.
The American Diabetes Association is recommending screening for prediabetes and type 2 diabetes in children 10 years and older who are overweight and obese and have 2 of the following risk factors.
1      Family history of type 2 diabetes
2      Minority race or ethnicity
3      Signs of insulin resistance or conditions associated with insulin resistance
4      Maternal history of diabetes

There are many ways dietitians can improve outcomes for their patients with type 2 diabetes. First, they must help parents understand what diabetes is and how they can help their child. Since lifestyle factors play a large role in the management of type 2 diabetes, it is helpful to assess the family on their health beliefs and behaviors.  It is important to focus on the parents because parental obesity is a predictor of childhood obesity. Helping counsel the parents may ultimately improve outcomes for the child.
Another way to improve outcomes is to make culturally appropriate recommendations. As registered dietitians, we must show that all cultures can fit into someone’s life who has diabetes. Instead of focusing on eliminating certain foods, it may be helpful to focus on portion control. Dietitians must also be careful about labeling food “good” and “bad.” We want that child to be able to live as normal of a life as possible and not feel restricted with their food options. Parents should monitor the child’s blood glucose so they know when to decrease portions or provide different carbohydrate options at different times. Finally, dietitians must be sensitive to what the family can provide. Majority of people with type 2 diabetes come from families in the lowest annual household income category. This may limit the types of foods they can buy. It is important to take that into consideration when counseling a patient so they do not feel embarrassed for what they can and cannot afford.

I think it is extremely important for dietitians to remain on the forefront of diabetes and show our worth when it comes to outcomes. With diabetes continuing to be on the rise, we must understand the best techniques to counsel patients in order for them to have the most successful outcomes possible.

-SR

http://www.todaysdietitian.com/newarchives/1117p32.shtml

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