Diabetes Dateline

NDEP News

New Online Resources on Children With Diabetes Available on the National Diabetes Education Program's Website at www.ndep.nih.gov

Diabetes is one of the most common chronic diseases in school-aged children, affecting about 151,000 young people in the United States, or about one in every 400 to 500 people under 20 years of age. Each year, more than 13,000 youths are diagnosed with type 1 diabetes, formerly called juvenile or insulin-dependent diabetes.

In recent years, health care providers have found increasing numbers of children and teens with type 2 diabetes, a disease usually diagnosed in adults over age 40. Although there are no national prevalence data, some clinics report that one-third to one-half of all new cases of diabetes in children are now type 2. American Indian, African American, and Hispanic/Latino young people who are obese and have a family history of type 2 diabetes are at especially high risk for the disease. With 13 percent of U.S. children either overweight or obese—more than double the number two decades ago—type 2 diabetes is emerging as a major public health threat.

Early detection of type 1 or type 2 diabetes in children is as important as it is with adults, given the serious complications associated with the disease, such as cardiovascular disease, nephropathy, neuropathy, and retinopathy. The most common symptoms of type 1 and type 2 diabetes in children include ongoing fatigue, increased thirst, frequent urination, recent weight loss, blurred vision, frequent infections, and slow healing of wounds or sores. However, as with adults, some children with type 2 diabetes may not have symptoms. Health care providers should consider testing children for type 2 diabetes who have additional risk factors. According to the American Diabetes Association Consensus Statement "Type 2 Diabetes in Children and Adolescents" (Diabetes Care 23:381–389, 2000), testing is recommended for overweight children who have any two of the following risk factors:

• a family history of type 2 diabetes in first- and second-degree relatives



• being of Hispanic/Latino, African American, American Indian, Asian American, or Pacific Islander descent



• the presence of physical signs of insulin resistance, such as acanthosis nigricans, or having conditions associated with insulin resistance, such as polycystic ovary syndrome

Once diabetes is diagnosed, health care providers need to work with the children and their families to develop an individualized diabetes care plan for managing blood glucose levels within a target range. The care plan should include the child's target blood glucose goals, meal and snack plan, recommended physical activities, blood glucose monitoring, and prescribed medications.

A diagnosis of diabetes is stressful not only for the child, but also for the family. Children face unique physical and psychosocial issues in dealing with diabetes 24 hours a day, 7 days a week, especially in making the lifestyle changes that are required for effective diabetes management. Primary care providers can help the family to identify resources such as mental health counseling, diabetes education classes, financial and social services, and other community resources.

Working with representatives from the leading diabetes, pediatric, primary care, nutrition, and education organizations, the National Diabetes Education Program has developed online web-based resources to inform health care professionals, parents, and schools about the onset and management of diabetes in children.

The following resources are available on the NDEP website, www.ndep.nih.gov:

To order materials on diabetes management for your practice, call the National Diabetes Education Program at 1–800–438–5383.

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