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For the first time ever, the American Academy of Pediatrics (AAP) has issued guidelines for the management of Type 2 diabetes. Until now type 2 diabetes has been considered an adult onset disease, but pediatricians are seeing more and more children either pre-diabetic or fully engaged in Type 2. Many physicians believe that the increase in type 2 diabetes is directly related to the rise in childhood obesity.
Type 1diabetes is a chronic condition that is also known as juvenile diabetes or insulin dependent diabetes. It is often a genetic disease or can be caused by certain viruses. With type 1 diabetes, the pancreas produces little or no insulin. It is not curable but can be managed.
Type 2 diabetes is much more common and is rising rapidly among children and teens. It now accounts for up to one in three new cases between the ages of 10 and 18.
Why has the AAP decided guidelines are now needed? Because type 2 diabetes was once considered an adult disease- not a childhood disease.
"Few providers have been trained in managing type 2 diabetes in children and, to date, few medications have been evaluated for safety and [effectiveness] in children," says co-author Janet Silverstein, MD, professor of pediatrics at the University of Florida and chief of endocrinology at Shands Hospital in Gainesville.
"This is a real issue in the pediatric population. It's something that many of us as pediatricians didn't grow up with because we just didn't see it very often," she says.
Proper diagnosis is paramount to the recommended guidelines. Type 1 or type 2 diabetes diagnoses are not always clear-cut and can take time for an accurate diagnosis.
The guidelines recommend giving insulin to patients if it's not clear whether they have type 1 or type 2 diabetes. If type 2 diabetes is confirmed, lifestyle changes along with the medication metformin are recommended. Metformin and insulin are the only two blood sugar-lowering medicati