Lowering Risk for Type 2 Diabetes in High-risk Youth

Among children and youth who develop type 2 diabetes (T2DM) there are a number of genetic and environmental factors that lead to a combination of insulin resistance and relative-cell secretory failure of the pancreas. These factors include ethnicity (highest in American Indian youth), obesity, sedentary behavior, family history of T2DM, puberty, low birth weight, intrauterine diabetes exposure and female gender. The American Diabetes Association (ADA)has recommended guidelines to screen children and youth for diabetes risk. School nurses in a National Association of School Nurses' program use the ADA guidelines, and then refer at-risk children to a health care provider for further evaluation and intervention. The HEALTHY trial funded by the National Institutes of Health is assessing whether school-based strategies can reduce diabetes risk. Prevention and intervention of overweight and obesity in children-a risk factor for the development of T2DM in children and youth-is a shared responsibility among parents, schools, health care providers and communities.