Speaker 1: It seems to be an epidemic of a phenomenon that you thought it never would happen in pediatrics. Only in diabetes, diabetes when something gets like a little heavy. How come that’s happening and how can we dress this and may be prevent that.
Speaker 2: Well, I think it’s a very, very good question, we’re seeing a rise now in that kind of diabetes in childhood to the point where it may soon surpass. The typical kind of diabetes that we see in childhood, which is juvenile diabetes caused by a completely different mechanism. The single most important cause of this type of diabetes in childhood is over weight, and as overweight worsens and we don’t see any end inside, and so does the epidemic of type 2 diabetes.
I think it’s important to stress that it can be prevented, if children are brought to medical attention early enough and the medical attention is appropriate and sensitive enough to preserve the child’s self-esteem, to preserve the child’s sense of self efficacy; then those kinds of intervention may help those children for stall the onset of this kind of diabetes, and of course, the complications of that diabetes the loss of limb, loss of vision, the loss of kidney function and of course, premature death.
Speaker 1: This type 2 diabetes is different type 1, whereas type 1, they don’t make insulin, this one they seemed to make insulin?
Speaker 2: Individuals with typical juvenile diabetes suffer from a condition where the body destroys the ability of pancreas, which is a tubular shaped gland that sits behind the stomach and makes insulin, and then doing so destroys the body’s ability to make that chemical messenger called insulin.
Insulin carries sugar from the blood into the factories, which lives inside each and every cell. This is different than type 2 diabetes where we’re making a lot of insulin, but it’s just not enough to feed the size of our body and after a while the pancreas tires out and can’t making enough insulin to keep up with the size of the body and that’s when type 2 diabetes occurs.
Clearly, the treatments and approaches to them are different. In type 1 diabetes, you must take insulin; there is no other form treatment. In type 2 diabetes, in the early stages, if its quite early enough then certainly exercise diet and maybe some oral medication may suffice and I think it’s an important time for me to reinforce and distress with parents that if you see your child bedwetting and a child that’s previously been toilet -- please bring this to the intention of your primary care provider as soon as possible, it may be one of the earliest signs that your child has infected with diabetes. If they experience excessive thirst or they experience weight loss despite adequate intake of food, that too maybe a sign of diabetes and I would urge you to bring those kinds of symptoms to the attention of your primary care provider as soon as possible.
Speaker 1: As a diabetic expert, today we can get diabetes pretty well controlled with different types of insulins is correct?
Speaker 2: There is no question that the advances in diabetes management today have really allowed our childrens to live full, healthy, and happy life spans. We have insulin treatments that are far superior to what they were years ago and closely mimic what the pancreas typically does. We have insulin delivery devices like for example insulin pumps, which allow the insulin to be delivered almost as well as the pancreas does and we have wonderful monitoring devices such as finger stick, blood sugar testing, and continue those glucose monitors that allow us to know what the blood sugars are almost every minute of the day. These advances have lengthened the life span of children with diabetes, so that they can all live happy and healthy long lives.
Speaker 1: So we all managed diabetic could almost expect to live a full life like a normal person?
Speaker 2: Without question a child who has diabetes that takes care of themselves in a family that strives to take care of their child the diabetes as challenging as that maybe, the pay off is enormous and I think that if they do, they’ll see their children live long, happy, and healthy lives without any long-term complications.
Speaker 1: So, the best treatment for type 2 diabetic would be prevention that would be exercising at early age, weight control in early age? Is that true?
Speaker 2: I think for all children regardless of whether or not they develop type 2 diabetes, but certainly and those at risks where family members may have diabetes those are families that should paying particular attention to be in physically active and eating right, so that they can prevent the onset of type 2 diabetes in their children.
Speaker 1: Thank you very much.
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