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Type 2 Diabetes in Children

The number of children that have type 2 diabetes is on the rise. Accurate numbers about how many children have this condition are hard to obtain, because the disease may have been present for a while before it is diagnosed. Anywhere between 8 to 46 percent of children with diabetes referred to pediatric centers have type 2 diabetes. The increase in childhood obesity is likely to be the main factor driving this increased incidence of type 2 diabetes.

Your child might be diagnosed with diabetes during routine screening or because she may be unwell. The American Diabetes Association recommends screening any overweight child (more than 120 percent ideal body weight, body mass index greater than 85 percent) who has two of the following features:

Strong family history of type 2 diabetes (parents, siblings, uncles, aunts, grandparents, nephew, niece, half sibling)
High-risk ethnic background: African-American, Hispanic, American Indian, Asian, Pacifi c Islander
Evidence for insulin resistance or presence of conditions associated with insulin resistance, such as darkening of the skin under the armpits or around the neck (acanthosis nigricans), high blood pressure, high triglyceride levels, or polycystic ovarian syndrome

The screening starts at age ten or at puberty, whichever is earlier, and is done every two years.

High glucose levels may lead to yeast or bladder infections. Occasionally, the child may present in hyperosmolar coma or even diabetic ketoacidosis (see Chapter 3). Also keep in mind that, in children, it is sometimes diffi cult to distinguish between type 1 and type 2 diabetes.



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