Guidelines for young people with type 2 diabetes
Thursday, 5 November 2020
The rate of new cases of diabetes in children and adolescents is increasing. The rise in type 2 diabetes among the young is thought to be linked to the rise in obesity.
Those most at risk are children and adolescents of Aboriginal, Torres Strait Island, Pacific Island or Maori descent.
One study showed that Indigenous children and adolescents in Western Australia had rates of diabetes six times higher than non-Indigenous young people.
Type 2 diabetes in young people is very concerning as the health outcomes are even more serious than for those who are diagnosed with type 1 diabetes, or adults diagnosed with type 2 diabetes.
Complication risks rise with young diagnosis
The complications of diabetes are seen earlier in those diagnosed at a young age, and this can reduce quality of life and life expectancy.
Until now, Australian guidelines for type 2 diabetes have focused on adult care only.
A working group organised by the Australasian Paediatric Endocrine Group (APEG) developed new guidelines specifically for children and adolescents.
The guidelines help to advise health care providers on all aspects of screening and management of diabetes in children and adolescents.
Find out early
It is very important to identify diabetes early, and to link in to health care providers for treatment at an early stage to get the best long-term health outcomes.
The guidelines include a dedicated section on special considerations for children and adolescents from Indigenous backgrounds.
Key features of the new guidelines include the need for:
- Screening for diabetes every 2 to 3 years for children aged 10 years or older who have any risk factors: overweight, obesity, family history of gestational or type 2 diabetes, high blood pressure, high cholesterol levels, fatty liver, polycystic ovarian disease, small for gestational age, or use of medications for depression, anxiety, insomnia and mood disorders.
- Tighter diabetes targets than adults (HbA1c less than 48 mmol/mol [< 6.5%])
- Access to a specialised multidisciplinary team for young people with diabetes
- Regular appointments with the health care team
- An individual plan for self-blood glucose monitoring
- Lifestyle education which is individualised, age appropriate and includes the family
- Transition to a specialised multidisciplinary adult team.
The guidelines also give advice on medications and insulin.
They address specific barriers and issues known for young people including engagement with health care providers, the need for positive and non-judgemental language, addressing specific beliefs and concerns, and the involvement of family and peers.