Back to Journals » Diabetes, Metabolic Syndrome and Obesity » Volume 2

Management of obesity, insulin resistance and type 2 diabetes in children: consensus and controversy

Authors Fleischman A, Rhodes E

Published 27 November 2009 Volume 2009:2 Pages 185—202

DOI https://doi.org/10.2147/DMSO.S4946

Review by Single anonymous peer review

Peer reviewer comments 2



Amy Fleischman, Erinn T Rhodes

Division of Endocrinology, Children’s Hospital Boston, Boston, MA, United States

Abstract: Childhood obesity has become a national and international epidemic. The prevalence and incidence of type 2 diabetes in youth have been increasing, and type 2 diabetes is one of the most challenging complications of obesity in childhood. Comprehensive lifestyle interventions that include attention to dietary change, increased physical activity and behavior change appear to be required for the successful treatment of pediatric obesity. In particular, aspects of behavioral interventions that have been identified as contributing to effectiveness have included intensity, parent/family participation, addressing healthy dietary change, promoting physical activity, and involving behavioral management principles such as goal setting. A multidisciplinary team approach is required for successful management of type 2 diabetes in youth as well. As with many therapies in pediatrics, clinical trials and support for treatments of obesity and type 2 diabetes in youth lag behind adult data. Pediatric recommendations may be extrapolated from adult data and are often based on consensus guidelines. Type 2 diabetes in children is most commonly managed with lifestyle modification and medications, metformin and/or insulin, the only medications currently approved for use in children. However, many opportunities exist for ongoing research to clarify optimal management for obesity and type 2 diabetes in youth.

Keywords: children, obesity, type 2 diabetes, metformin, insulin, bariatric surgery

Creative Commons License © 2009 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.