Aggressive intervention recommended to prevent pediatric diabetes, review concludes

Type 2 diabetes, once considered an adult disease, is increasingly causing health complications among American youth. Researchers who recently published a review in the Journal of Osteopathic Medicine are recommending that physicians work more aggressively to 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 review 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.”

Risk factors

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 beta 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 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.

Managing the disease

The American Diabetes Association recommends considering food insecurity, housing instability, and potential financial limitations when working with families to create a plan to manage T2 diabetes. Clinicians should also screen for stress, isolation, depression, anxiety, substance abuse and eating disorders 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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