Children are at risk of diabetes too
Type 2 diabetes is also known as adult-onset diabetes because it's a disease that starts in adulthood — that is, until recently. The past decade has seen an alarming increase in type 2 cases in children. Before the 1990s, type 2 accounted for less than 4 percent of diabetes cases in kids. Now it makes up about 45 percent, according to the American Diabetes Association (ADA).
Why is this happening? Researchers point to a dramatic jump in juvenile obesity. Today about 25 percent of American children are overweight-twice the number in the 1 970s. In an attempt to clarify the diabetes risk to heavy kids, Yale researchers writing in The New England Journal of Medicine in March 2002 reported that, of 167 obese children and adolescents they studied, about a quarter were already glucose intolerant-one step down the path to diabetes.
"This is all very new, and we're still not exactly sure how to treat type 2 diabetes in children," says Sonia Caprio, M.D., director of Yale's Pediatric Obesity/Type 2 Diabetes Clinic. One emerging controversy is whether doctors should prescribe medications to treat kids who have type 2 diabetes or to prevent it in children who are glucose intolerant. Studies in adults suggest that drugs can significantly reduce risks, but the side effects of drug treatment in children are unknown. A National Institutes of Health study now being organized to examine the issue won't provide results until around 2008.
Less controversial are the benefits of addressing lifestyle issues that contribute to the obesity epidemic. "More food is available to children at any time of day than has ever been the case before," says Dr. Caprio. "We promote food consumption in kids, especially high-calorie snacks and soft drinks, which are available from vending machines in schools." Supersize portions are another problem. "Kids are used to immense servings in restaurants," she says. "They don't even think about it."
On top of that, children are far less physically active than they were in the past, according to Dr. Caprio. Because of distance and safety issues, children seldom walk to school, and physical education is losing ground to other curricula. According to the ADA, only 25 percent of high schools still have daily gym classes. Back at home, kids spend increasing amounts of time on sedentary activities, such as watching TV, using computers, or playing video games, says Dr. Caprio.
To counter these trends, she supports the decision by some schools to screen children for obesity and notify parents of health risks. The ADA recommends diabetes testing for overweight children with at least two other risk factors—for example family history, high blood pressure, or membership in an at-risk ethnic group (Native American, African American, Asian America, Hispanic American, and Pacific Islander). But parents are the real focus of change. "Parents need to learn more about proper nutrition and go outside to play more themselves — like most of our parents did 30 years ago."
Why is this happening? Researchers point to a dramatic jump in juvenile obesity. Today about 25 percent of American children are overweight-twice the number in the 1 970s. In an attempt to clarify the diabetes risk to heavy kids, Yale researchers writing in The New England Journal of Medicine in March 2002 reported that, of 167 obese children and adolescents they studied, about a quarter were already glucose intolerant-one step down the path to diabetes.
"This is all very new, and we're still not exactly sure how to treat type 2 diabetes in children," says Sonia Caprio, M.D., director of Yale's Pediatric Obesity/Type 2 Diabetes Clinic. One emerging controversy is whether doctors should prescribe medications to treat kids who have type 2 diabetes or to prevent it in children who are glucose intolerant. Studies in adults suggest that drugs can significantly reduce risks, but the side effects of drug treatment in children are unknown. A National Institutes of Health study now being organized to examine the issue won't provide results until around 2008.
Less controversial are the benefits of addressing lifestyle issues that contribute to the obesity epidemic. "More food is available to children at any time of day than has ever been the case before," says Dr. Caprio. "We promote food consumption in kids, especially high-calorie snacks and soft drinks, which are available from vending machines in schools." Supersize portions are another problem. "Kids are used to immense servings in restaurants," she says. "They don't even think about it."
On top of that, children are far less physically active than they were in the past, according to Dr. Caprio. Because of distance and safety issues, children seldom walk to school, and physical education is losing ground to other curricula. According to the ADA, only 25 percent of high schools still have daily gym classes. Back at home, kids spend increasing amounts of time on sedentary activities, such as watching TV, using computers, or playing video games, says Dr. Caprio.
To counter these trends, she supports the decision by some schools to screen children for obesity and notify parents of health risks. The ADA recommends diabetes testing for overweight children with at least two other risk factors—for example family history, high blood pressure, or membership in an at-risk ethnic group (Native American, African American, Asian America, Hispanic American, and Pacific Islander). But parents are the real focus of change. "Parents need to learn more about proper nutrition and go outside to play more themselves — like most of our parents did 30 years ago."
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