Children have long been diagnosed with Type 1 diabetes, in which the body fails to make enough insulin-producing cells to process glucose in the blood, but doctors are now seeing an increasing number of children with type 2 diabetes, in which fat cells that enlarge with weight gain thwart the body's ability to break down sugars. Up to a third of cases being diagnosed in kids these days are Type 2, which generally develops later in life, generally after age 40. "We're seeing it much more than we did before," says Dr. Janet Silverstein, co-author of the new American Academy of Pediatrics guidelines on diabetes and professor of pediatrics at the University of Florida. "Many pediatricians were never trained in managing Type 2 because it just wasn't a disease we used to see. It was a disease of adulthood. But as we're seeing more obesity in kids, we're seeing adult diseases in childhood."
The guidelines, which are the first of their kind for kids between the ages of 10 and 18, were developed in collaboration with the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians and the Academy of Nutrition and Dietetics.
They emphasize the importance of distinguishing between type 1 and type 2 to determine an appropriate treatment plan. Children with type 2 don't necessarily need insulin. They may initially be treated with medication that increases their sensitivity to insulin. And they should be encouraged to move: doctors should advise them to exercise at least an hour a day and limit screen time that's not related to schoolwork to under two hours a day.
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