The effect of a school-based intervention on the incidence of type 2 diabetes mellitus in children.

摘要

Problem: Across the globe there is currently an epidemic of type 2 diabetes mellitus in children younger than 16. Type 2 diabetes mellitus (T2D) has historically been an adult disease with late onset generally diagnosed after the age of 40 years. In both adults and children the disease is associated with obesity and often times there are few or no defining symptoms. As the number of obese children increases worldwide, there can be expected to also be an increase in the number of children with T2D. Methods: Peer-reviewed clinical trials from the past five years that were relevant to the type 2 diabetes and obesity epidemics in the pediatric population were included in the literature review. Results: The major cause of the increasing prevalence of type 2 diabetes in children and young adults is the increase in childhood obesity due either to genetic factors or the patients' lifestyle. Co-morbid medical conditions other than obesity are also on the rise in these youth, causing children to have severe health issues which were previously observed in only adults. When lifestyle modifications do not work, most pediatric patients will begin oral hypoglycemic or insulin therapy and will continue this therapy throughout their adult life. Conclusions: Type 2 diabetes poses a huge risk for patients clinically, causing a premature decline in health at a very early age, and puts the patient at an increased risk for other co-morbid conditions. It has been difficult for children to achieve glycemic control using lifestyle modifications alone, so many go on to require pharmacologic therapy.