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Recommendations made for childhood type 2 diabetes

By Editor
30th July 2019
Type 2 diabetes, Type 2 prevention

Children who are obese and have type 2 diabetes have “low self-esteem” and are prone to “stress and depression”, according to a leading paediatrician. 

In response, Professor Timothy Barrett, Professor of Paediatrics at the University of Birmingham, has helped develop a series of recommendations in a bid to reduce type 2 diabetes rates among young people.

They were made during an All-Party Parliamentary Group for Diabetes (APPG) meeting which was dedicated to childhood obesity and type 2 diabetes.

Professor Barrett runs a fortnightly clinic where he focuses on children and young people with type 2 diabetes. His research has been in describing the pattern of type 2 diabetes in children and young people, and clinical trials of new treatments.

If we don’t learn how to engage children with their diabetes, it can be hard to get them to take it seriously in later life

Dr Billy White, Paediatrician and Consultant at University College London Hospitals

He said: “Most children that I see with obesity, don’t want to be fat, have low self-esteem and high rates of stress and depression.”

He told the meeting that a lot of  families do not see type 2 diabetes as a serious condition, which for these children means the condition is probably for life. This means diabetes complications are more likely during the prime of their lives, when they should be having families and being economically productive.

Dr Billy White, Paediatrician and Consultant at University College London Hospitals, is a consultant in adolescent medicine, having spent four years doing diabetes clinics during his training.

He has obtained a PHD in obesity and published a review on type 2 diabetes among teenagers.

Dr White said: “We can agree that being teenager today can be hard and on top of that having type 2 diabetes is an additional challenge. There is a massive stigma, school pressure, you are sleeping less, having mood disorders and being labelled a ‘bad patient’. If we don’t learn how to engage children with their diabetes, it can be hard to get them to take it seriously in later life.”

Expertise and trials

He told session attendees that more research studies are needed to increase expertise and trial new drugs for young people. More specialist centres are needed so more time can be spent with children who have type 2 diabetes.

A series of recommendations were made at the end of the meeting, which were as follows:

  • Restore community paediatric dieticians. Since the withdrawal of this service over the last 8 years, it has become increasingly difficult to deliver consistent, regular dietetic and lifestyle advice to affected children in the community.
  • Maintain the NHS England Best Practice Tariff. This has delivered the longest sustained improvement in childhood diabetes care and outcomes in England and Wales.
  • Request the National Institute for Health Research, Health Technology Assessment programme, a commissioned call for research into nutritional interventions in childhood type 2 diabetes. This would support a proposal to investigate the effects of a low-calorie diet, or possibly a low carbohydrate diet.
  • Create a society where the healthy choice is the easy choice by the Government acting on the measures in the Childhood Obesity Plan.
  • Prioritise research in to the safety, effectiveness and acceptability of medications to treat type 2 diabetes in children and young people.
  • Ensure children and young people with type 2 diabetes have access to expert clinicians who are trained to manage and research the condition and the challenges it presents.
  • Young people with type 2 diabetes who may also have other complex needs should have access to technology which would allow their sugar levels to be measured automatically without finger pricking. This is already being used on people with type 1 diabetes. It will be very useful in maintaining a good control for their diabetic condition and provide a non-invasive way to monitor them when they are asleep.
  • Dieticians work more with the community based on their ethnicity to discuss their types of food, calorie content, method of preparation and portion control to educate people and make them more aware of the benefits of making healthy diet choices.

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