How to improve the care of children and adolescents with type 2 diabetes

The Centre has contributed to a new Australasian guideline to improve the care of children and adolescents with type 2 diabetes

By Prof Jane Speight

The rate of type 2 diabetes in children and adolescents has risen sharply in the past 30 years, but the numbers of young people affected remain relatively small. As a result, there has been less research attention to the needs of this group, compared to adolescents with type 1 diabetes or adults with type 2 diabetes. Also, until recently, there were no Australian guidelines specific to the needs of this group, and health professionals had to rely on guidelines developed for the care of diabetes in adults.

In July 2020, a new Australasian guideline was published by the Australasian Paediatric Endocrine Group in the Medical Journal of Australia. The main recommendations are in relation to screening for and diagnosis of type 2 diabetes, as well as all aspects of diabetes care, including medications, education and psychosocial aspects. Importantly, the guideline acknowledges the high rates of depressive symptoms, disordered eating and high risk-taking behaviours in this young group. While these psychosocial issues are important in their own right, they are also likely to affect the ability and willingness of the young person (and their family) to take medications as recommended. This can impact on the management of diabetes and risk for long-term complications. Therefore, the guideline recommends early identification of these problems and prompt referral to psychology, counselling and/or social work services to ensure the young person (and their family) receives the support they need.

Importantly, the guideline includes a series of strategies and issues to consider when supporting diabetes care in children and adolescents from Aboriginal and Torres Strait Islander communities.  It suggests that health professionals engage in a culturally and age-appropriate way; avoid language that blames and shames; keep messages positive, simple and easy to understand; take a whole of family approach and acknowledge the important role of social support; do whatever possible to minimise feelings of guilt and stigma. Of course, many of these recommendations are also highly relevant for children and adolescents from non-indigenous communities.

You can access the full guideline here and an open access review paper here by Dr Sarah Jaser, in which she describes some key issues faced by children and adolescents with type 2 diabetes.

For more about adolescents with diabetes, check our our other blogs.

Peña AS, Curran JA, Fuery M, George C, Jefferies CA, Lobley K, Ludwig K, Maguire AM, Papadimos E, Peters A, Sellars F, Speight J, Titmuss A, Wilson D, Wong J, Worth C, Dahiya R. Screening, assessment and management of type 2 diabetes mellitus in children and adolescents: Australasian Paediatric Endocrine Group guidelines. Medical Journal of Australia, 2020; 213(1): 30-43

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