Looking after your child’s wellbeing when he or she has type 2 diabetes can be challenging, and so the American Academy of Paediatrics (AAP) has issues the first ever guidelines for managing type 2 diabetes in children aged from 10 to 18 years.
It used to be that type 2 diabetes was only a wellness concern for adults, and it rarely occurred in children. However, this is no longer the case, and due to the fact that type 2 diabetes among children emerged so rapidly, many doctors face a difficult task of having to treat children with an ‘adult disease’, when they are used to dealing with type 1 diabetes in children, not type 2.
According to the AAP, now is the time to help doctors who have to care for paediatric patients who have developed type 2 diabetes, and it has issued a Clinical Practice Guideline to that effect. The recommendations given by the guideline are based on evidence, and are specifically tailored to 10 to 18 year old patients who have type 2 diabetes. The AAP says, ‘The guidelines are the first of their kind for this age group.’
The guidelines were written in consultation with the Academy of Nutrition and Dietetics, the American Diabetes Association, the American Academy of Family Physicians, and the Paediatric Endocrine Society, and were published with an accompanying Technical Report in the Academy’s journal Paediatrics.
One recommendation that the guidelines make is that young people who are very hyperglycaemic, known as ketosis, or those whose diabetes cannot be clearly defined as a type 1 or 2 should start treatment with insulin, but in all other cases, children and teenagers should begin with metformin, as well as diet and exercise. There are also advisements for diet, implementing insulin regimes, monitoring children’s glycaemic control and physical activity.
The guidelines’ authors wrote, ‘The clinical practice guideline underwent peer review before it was approved by the AAP. This clinical practice guideline is not intended to replace clinical judgment or establish a protocol for the care of all children with T2DM, and its recommendations may not provide the only appropriate approach to the management of children with T2DM. Providers should consult experts trained in the care of children and adolescents with T2DM when treatment goals are not met or when therapy with insulin is initiated.’
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