MANAGING AND PREVENTING DIABETES IN CHILDREN AND ADOLESCENT

How does diabetes affect children and teenagers? Diabetes mellitus involves absence of insulin secretion (type 1) or peripheral insulin resistance (type 2), causing hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia, polyphagia, polyuria, and weight loss. Diagnosis is by measuring plasma glucose levels. Treatment depends on type but includes drugs that reduce blood glucose levels, diet, and exercise.

Diabetes rates are rising in young people. Early detection and treatment in children and teenagers can improve their health and wellness throughout life. The types of diabetes mellitus (diabetes) in children are similar to those in adults, but psychosocial problems are different and can complicate treatment.

• Type 1 diabetes is the most common type in children, accounting for two thirds of new cases in children of all ethnic groups. It is one of the most common chronic childhood diseases, occurring in 1 in 350 children by age 18; the incidence has recently been increasing, particularly in children
• Type 2 diabetes, once rare in children, has been increasing in frequency in parallel with the increase in childhood obesity (see obesity in children). It typically manifests after puberty, with the highest rate between age 15 years and 19 years (see obesity in adolescents).
• Monogenic forms of diabetes, previously termed maturity-onset diabetes of youth (MODY), are not considered type 1 or type 2 (although they are sometimes mistaken for them) and are uncommon (1 to 4% of cases).
• Prediabetes is impaired glucose regulation resulting in intermediate glucose levels that are too high to be normal but do not meet criteria for diabetes. In obese adolescents, prediabetes may be transient (with reversion to normal in 2 years in 60%) or progress to diabetes, especially in adolescents who persistently gain weight. Prediabetes is associated with the metabolic syndrome (impaired glucose regulation, dyslipidemia, hypertension, obesity).

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