[pronut-hiv] Type 2 Diabetes in Children and Adolescents - The Next Epidemic?

["ProNut-HIV" <pronut-hiv@healthnet.org>]

Type 2 Diabetes in Children and Adolescents - The Next Epidemic?

Eva M. Vivian  

Abstract
Objective: To provide an overview of the incidence of type 2 diabetes
in children and adolescents and provide direction for clinicians who
care for children and adolescents.
Research Design and Method: The data presented in this review were
obtained from published literature and abstracts presented at scientific
meetings. Clinical trials and review articles were identified using the
search terms 'metabolic syndrome', 'type 2 diabetes mellitus',
'children', and 'adolescents' in a MEDLINE search from 1995-2005.
Additionally, the bibliographies of the identified articles were
reviewed.
Results: Type 2 diabetes is rising rapidly in children and adolescents
worldwide. Changing a child's living environment to include physical
activity, and a well balanced, low fat, high fiber diet, are important
for the maintenance of a desirable body weight and improving insulin
sensitivity. Maintaining euglycemia with metformin, sulfonylureas,
thiazolinediones, and insulin is recommended. Effective treatment of
co-morbid problems such as hypertension and dyslipidemia can decrease
the risk of cardiovascular complications.
Conclusions: The prevalence of type 2 diabetes in children will
continue to rise until effective measures are taken to prevent obesity
in this age group. Ensuring that children have a well balanced low fat,
high fiber, diet, combined with physical activity, will promote weight
loss or maintenance, improve insulin sensitivity, and decrease the risk
of diabetes and cardiovascular disease. Pharmacologic therapy is
recommended for children who are unable to achieve satisfactory glycemic
control through physical activity and diet.

Eva M. Vivian, Western University of Health Sciences, College of
Pharmacy, Pomona, California, USA