Primary Prevention
Primary prevention methods, those that prevent children and teens from getting type 2 diabetes, are key to reducing the prevalence of type 2 diabetes in the United States.
The Mayo Clinic identifies several components of primary prevention of type 2 diabetes such as increased physical fitness, nutrition, familial education, and attention to the most at-risk members of society so all information provided in this section of the libguide will emphasize those components.
Primary Prevention of Type 2 Diabetes in American Youth: A Literature Review
While there is still some question as to whether the prevalence of pediatric type 2 diabetes in the United States should be characterized as an “epidemic” (Goran, et al 2008), statistics show that diabetes diagnoses in youths ages 12-19 years old have steadily increased from 9% in 1999 to 23% in 2008 (Stein, 2012). Children and adolescents diagnosed with type 2 diabetes are often overweight, have a family history of diabetes, are poor, and are of a minority race or ethnicity (Berry, et al, 2006; Goran, et al, 2008; McKenzie, et al, 1998; St Onge, et al 2006; Story,et al, 1998). Additionally, Budd (2006) and St Onge (2006) also identified environmental characteristics associated with pediatric type II diabetes, such as media and food industry concerns. All experts seem to agree that no one socio-economic factor is fully responsible for the increase in type 2 diabetes in children and adolescents (Berry, et al , 2006; Budd, 2006) and that approaching prevention of pediatric type 2 diabetes should come from several different directions.
The first and foremost intervention for prevention of type 2 diabetes in children and teens is medical based. New health guidelines advise pediatric doctors to monitor A1C levels and weight of children at risk (Castillo, 2013; CDC, 2013; Deckelbaum & Williams, 2012; WebMD, 2010) and others suggest medical interventions at fetal and maternal stages (CDC, 2013; Nolan, et al 2011). Some experts have suggested that school-based interventions where students learn and practice more active lifestyles and healthy eating can (CDC, 2013; Berry, et al 2006; Story,et al, 1998). Other studies and research have proposed that community-based interventions such as special services or community-wide educational classes and information might also help to reduce type 2 diabetes in American children and adolescents (Deckelbaum & Williams, 2012; Story,et al, 1998; Teufel, Ritenbaugh, 1998; Valde, 2011). Another approach often advocated are family-based interventions where the entire family is educated and guided into more healthy and active lifestyles, with particular success in minority families (Deckelbaum & Williams, 2012; McKenzie, et al, 1998; Nolan, et al, 2011; Story,et al, 1998; WebMD, 2010). To address the social and cultural aspects, it has been recommended that advertising of unhealthful foods be regulated like tobacco advertising (Budd, 2006) as well as interventions that decrease diets high in fat and sugar, television and video game usage, and inactive lifestyles (Gregg, 2010; Berry,et al, 2006; Stein, 2013; St Onge, et al, 2006; Story, et all 1998). Last, another piece to the intervention of type 2 diabetes in youth is the need for more research into prevalence and genetics of the disease (Berry, et al, 2006; Goran, 2008; Imperatore, et al, 2012; Stein, 2013; Teufel & Ritenbaugh, 1998).
It is clear that type 2 diabetes interventions must be introduced in several aspects of the daily lives American youth to make a significant difference in primary prevention (Berry, et al, 2006; CDC, 2013: St Onge, et al, 2006). A recent study has shown small decreases in instances of obesity in low-income children ages 2-4 years of age (Pan, et al 2012) however the CDC has recently reported that without effective intervention the prevalence of type 2 diabetes stricken youth could almost quadruple from 22,000 in 2010 to 84,000 in 2050 (Imperatore, et al, 2012; CDC; 2013). The dismal outlook of pediatric cases of child and juvenile type 2 diabetes can be impacted greatly by the suggested medical, school, family, community, and social based interventions combining to change American lifestyles and diet by education, guidance, and research.
References
Berry, D., Urban, A., & Grey, M. (2006). Understanding the development and prevention of type 2 diabetes in youth (part 1) J Pediatr Health Care (Vol. 20, pp. 3-10). United States.
Budd, G. (2006). The development of Type 2 diabetes in youth J Pediatr Health Care (Vol. 20, pp. 357). United States.
Castillo, M. (2013). First-ever health guidelines issued for diabetic kids. CBS News. Retrieved at: http://www.cbsnews.com/8301-204_162-57566206/first-ever-health-guidelines-issued-for-diabetic-kids/
CDC (2013). School Health Index. Center for Disease Control. Retrieved at: http://www.cdc.gov/HealthyYouth/shi/index.htm
Deckelbaum, R. J., & Williams, C. L. (2012). Childhood obesity: the health issue. Obes Res, 9 Suppl 4, 239S-243S. doi: 10.1038/oby.2001.125
Goran, M. I., Davis, J., Kelly, L., Shaibi, G., Spruijt-Metz, D., Soni, S. M., & Weigensberg, M. (2008). Low prevalence of pediatric type 2 diabetes: where's the epidemic? J Pediatr (Vol. 152, pp. 753-755). United States.
Gregg, E. W. (2010). Are children the future of type 2 diabetes prevention? N Engl J Med (Vol. 362, pp. 548-550). United States.
Imperatore, G., Boyle, J. P., Thompson, T. J., Case, D., Dabelea, D., Hamman, R. F., Standiford, D. (2012). Projections of type 1 and type 2 diabetes burden in the U.S. population aged <20 years through 2050: dynamic modeling of incidence, mortality, and population growth Diabetes Care (Vol. 35, pp. 2515-2520). United States.
McKenzie, S. B., O'Connell, J., Smith, L. A., & Ottinger, W. E. (1998). A primary intervention program (pilot study) for Mexican American children at risk for type 2 diabetes. Diabetes Educ, 24(2), 180-187.
Nolan, C. J., Damm, P., & Prentki, M. (2011). Type 2 diabetes across generations: from pathophysiology to prevention and management Lancet (Vol. 378, pp. 169-181). England: 2011 Elsevier Ltd. Retrieved at: http://www.docvadis.it/assistenzadomiciliare/document/assistenzadomiciliare/type_2_diabetes_across_generations_from_pathophysiology_to_prevention_and_management/fr/metadata/files/0/file/Nolan.pdf
Pan, L., Blanck, H. M., Sherry, B., Dalenius, K., & Grummer-Strawn, L. M. (2012). Trends in the prevalence of extreme obesity among US preschool-aged children living in low-income families, 1998-2010 JAMA (Vol. 308, pp. 2563-2565). United States.
Story, M., Strauss, K. F., Zephier, E., & Broussard, B. A. (1998). Nutritional concerns in American Indian and Alaska Native children: transitions and future directions. J Am Diet Assoc (Vol. 98, pp. 170-176). United States.
Stein, Rob. (2012). A Dire Sign Of The Obesity Epidemic: Teen Diabetes Soaring, Study Finds. National Public Radio. Retrieved at http://www.npr.org/blogs/health/2012/05/21/153030283/a-dire-sign-of-the-obesity-epidemic-teen-diabetes-soaring-study-finds
St Onge, E. L., Motycka, C. A., & Rose, R. L. (2006). Type 2 diabetes in children: a growing epidemic. J Pediatr Pharmacol Ther, 11(4), 212-222. doi: 10.5863/1551-6776-11.4.212
Teufel, N. I., & Ritenbaugh, C. K. (1998). Development of a primary prevention program: insight gained in the Zuni Diabetes Prevention Program. Clin Pediatr (Phila), 37(2), 131-141.
Valde, J. (2011). Community Program to Prevent Diabetes in School Children. Journal Of Community Health Nursing, 28(4), 215-222. doi:http://dx.doi.org.hsl-ezproxy.ucdenver.edu/10.1080/07370016.2011.615183
WebMD. (2010). Type 2 Diabetes in Children—Prevention. WebMD.Com. Retrieved from: http://diabetes.webmd.com/tc/type-2-diabetes-in-children-prevention