Type 2 Diabetes Mellitus Among Children and Adolescents

Table of Contents

Introduction
Literature Review
Conclusion
References

Introduction

Type 2 diabetes mellitus (T2DM) is a prevalent illness affecting more than 16 million Americans. Its commonness among adults is on the rise, but more worrying is the recent recognition of this disease among children and adolescents. Researchers know little about the varying epidemiology, management and etiology of T2DM in pediatric inhabitants. Nevertheless, practitioners looking after the welfare of children and adolescents ought to consider the diagnosis of this disease in the children showing signs of hyperglycemia. The increase of T2DM among children and adolescents in the last five years has surfaced in parallel with a surprising rise in the number of young people who are obese. Along-with family weight, obesity emerges as a major risk factor for the increase of T2DM.

Literature Review

T2DM is one of the most rapidly increasing chronic illnesses in the US. In the last five years, health specialists have emphasized the need for its primary prevention (Fox; 2009). It has been repeatedly established that both asymptomatic and symptomatic patients of diabetes have an increased commonness of both macro-vascular and micro-vascular problems by the time the disease is first detected. The increased awareness concerning the aetiology, pathogenesis and the history of T2DM has brought about improved primary prevention measures of the disease. Even though a clearly accepted consensus concerning the early patho-genesis lacks, preventive strategies can be based-upon the current accessible knowledge. The increasing prevalence of T2DM, the seriousness of the disease, its numerous and harsh complications and the increasing socio-economic expenses, emphasize the significance of immediate preventive measures. Recently, a surprising increase in the occurrence of T2DM among children and adolescents in the US has been detected.

The young population in the US is becoming increasingly obese and inactive; researchers allege that T2DM will probably appear more often in younger generations than before. Puberty seems to play a significant role in the development of diabetes in young people. There is greater resistance to the insulin action during puberty that results in hyper-insulinaemia which brings about the manifestations of T2DM. One fundamental cause of this could be increased development of hormone secretion, and this outcome is modified by obesity. It is normally understood that diabetic patients with an early onset of T2DM may have a stronger genetic disposition compared to those whose onset period is older. Childhood and adolescence are life periods where peers lifestyles are adopted. This is the primary period where awareness and knowledge concerning T2DM and its risk factors ought to be distributed to the population.

Chiefly, the preventive message ought to entail factors related to practical advice about healthy eating habits and the support of physical activity; this should focus on the whole population, not just to high risk persons. The peer pressure amongst the young people is so rampant that benefits expected from such a population strategy to manage environmental risk factors for T2DM are likely to be extensive (Krentz; 2008). Efforts to prevent T2DM in children and adolescents should follow the same general pattern as that proposed for the prevention of T2DM in adults. Even though primary prevention attempts may be targeted for high-risk persons, the main approach must be based upon applying prevention measures at the population level. Prevention of T2MD in high-risk children and adolescents is predicated on the facility to categorize those at increased risk and offer them adequate service.

The population strategy is supposed to uphold the prevention of obesity and sufficient physical activity levels as desired standards for the whole community. These goals may not be easy to attain in the real world, but they are not irrational. In addition to general health support in the US, there is a need for healthcare experts to take part in developing and executing school and community based programmes to encourage better dietary and physical activity behaviors for all children and adolescents. Health specialists in USA say that, school programmes ought to encourage healthy eating habits, healthy food choices and adequate levels of physical activity. The commonness of T2DM in children and adolescents is greatly increasing in US. In the last five years, research studies show this disease has increased by 8% in children and adolescents. Health specialists in US fear that the disease will continue increasing among the young people if proper preventive measures are not implemented. 8-40% of young people recently diagnosed with diabetes in USA, is due to T2DM (Mazze; 2012). Reports show that the disease is affecting children who are as young as 8 years. These children are mostly in ethnic groups experiencing high risks of T2DM. Type 2 diabetes mellitus in children and adolescents is a serious illness with very poor results over ten to twenty years. The Internal Diabetes Federation proposes that supplies be made to provide the best medical care, prevent life-long problems and offer more studies so as to attain a better comprehension of the disease. Medical professionals in US state that in children and adolescents, T2DM is caused by an amalgamation of insensitivity to insulin and the failure to secrete beta-cell.

There are numerous environmental and hereditary risk factors for insensitivity to insulin and inadequate beta-cell secretion, for example obesity, inactive behaviors, family history T2DM, ethnicity, puberty, low weight of birth, contact to diabetes in the womb, and feminine gender. There is sufficient proof that some ethnic groups have higher vulnerability than others. Environmental factors also play a significant role in the growth of T2DM. Research studies show that Children and adolescents in US are inactive and have poor eating patterns thus causing obesity which is the main risk factor for T2DM (Bethel; 2008). Young people are unhealthy and unfit thus increasing the chances of acquiring type 2 diabetes mellitus.

The increase of type 2 diabetes among childhood and adolescence in US in the last few years is alarming, particularly when one considers the lasting public health and societal outcomes as these patients acquire persistent complications at a very tender age. The extensive treatment of young people with T2DM ought to focus on the metabolic derangements associated with the illness, for example obesity, resistance of insulin, insulin shortage, dyslipidemia, high blood pressure, and other early complications. Efforts ought to be marshaled to enhance the inadequate remedial armamentarium with newest drugs for adolescents with T2MD.GLP-1 receptor agonists are particularly optimistic and should be used in this population without obstruction (Krentz; 2008). Individualizing medications routines ought to be given consideration, taking into account the higher rates of T2MD in minority adolescents and children.

US medical experts claim that research study is required to create evidence-based proposals for glycemic goals and the preventive measures of micro-vascular and macro-vascular complications in adolescents with T2MD.Primary preventive measures of T2MD can be described as all measures intended to decrease the occurrence or commonness of the illness on the population level, by lessening its onset risks. This may be realized by adjusting the causal or fundamental risk factors for T2MD. Secondary prevention T2MD on the other hand, can be described as all approaches intended to decrease morbidity and mortality amongst patients diagnosed with T2MD. Since T2MD is a diverse and multi-factorial disease, prevention should be based upon amendment of numerous risk factors concurrently. If not, the potential for preventive measures will remain curtailed and inadequate.

The existing proof, however, shows that even one intervention, for instance increased physical activity in inactive children and adolescents or loss of weight in the obese, can bring about a noticeable decrease in the risk of T2MD (Codario; 2010).There are two constituents to the plan of a prevention measure: a population-based approach, for changing the way of life and those environmental risk factors which are the fundamental causes of T2MD among children and adolescents in US; and a high-risk measure for screening young people at high risk for T2MD and establishing preventive measures to this young generation on an individual basis.

Conclusion

According to current knowledge, the confirmed high risk persons are: those with a family history of T2DM; females who had gestational diabetes; individuals whose glucose level in their blood has been earlier found to be fairly increased; and individuals with hypertension. Additionally, obesity and sedentary children and adolescents have an increased risk for T2DM. In general, these high-risk young people are so many in US and these cases are continually increasing annually. As knowledge and preventive measures of the genetic predisposition for T2DM increases, ethnic groups with a higher genetic predisposition ought to be targeted.