From Poughkeepsie, New York, USA:
Do doctors tell parents that their children are prone to get type 2 diabetes before they develop it or do they just simply wait and tell them when the actually get type 2 diabetes?
In fact, in the last few years especially, both health professionals as well as the lay press have widely promulgated the link at all ages between being overweight, with a sedentary lifestyle and type 2 diabetes.
Additional comments from Dr. Jim Lane:My opinion is that pediatricians ought to be using the family history to educate families about risk of excess weight and diabetes.
Additional comments from Dr. John Schulga:It depends on the circumstances. If there are indicators that the child is at high risk of developing type 2 diabetes, such as increasing obesity with insulin resistance and abnormal glucose tolerance, then I think there is an obligation to warn the parents that their child is heading for a problem.
Additional comments from Dr. Marco Songini:One of the major goals of modern medicine is to prevent disease, not only to cure. As far as type 2 diabetes, what is currently worrying us is the new and increasing epidemic of type 2 among obese children. In fact, children were generally hit mostly by type 1 diabetes. But as obesity has widespread in newly-westernized (formerly third countries) populations such as Hispano-american, Polanesians and lastly Indian and Chinese, the incidence of type 2 has risen in younger generations as well. The only way to prevent it is to educate people at higher risk to better eat and exercise towards mantaining their body weight as close as possible to the ideal one. Thus, we do not simply wait and see when young people will eventually get diabetes.
Additional comments from Dr. Larry Deeb:I warn if I see obesity and Acanthosis Nigricans. One might as well try to intervene if I can.
Additional comments from Dr. Stuart Brink:If a child is obese, has acanthosis nigricans, high-normal or elevated blood pressure, abnormal lipids and any evidence for androgen excess, the chances of that child developing type 2 diabetes in the future as well as being at high risk for future cardiovascular problems (heart attacks, strokes) is very high. A good physician would counsel the family and begin to strategize to reduce excess caloric intake, increase energy expenditure and begin monitoring any such abnormalities. Family history of similar problems would increase the risk, obviously.
Original posting 28 Sep 2001
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