Indigenous children over the age of 10 who have risk factors for type 2 diabetes should be screened, new recommendations say.
The panel of clinicians, researchers and policymakers authoring the recommendations said the prevalence of T2DM among Indigenous children and teens was not only much greater than among the non-Indigenous but it was also rising, and those in remote areas were at an even greater risk.
Most young Indigenous people with T2DM were asymptomatic at diagnosis, had a family history of diabetes, were overweight and may have signs of hyperinsulinism, the authors said.
They recommended screening for Indigenous children over ten with any of these symptoms, or who showed signs of insulin resistance or dyslipidaemia, had received psychotropic therapy or who had been exposed to diabetes in utero.
Individualised management plans should include identification of risk and behavioural factors, treatment targets and psychosocial factors, as well as involvement of parents and Indigenous health workers.
Once T2DM had been diagnosed, the authors recommended an HbA1c target of <7%. While some clinicians treated Indigenous teens with obesity or metabolic syndrome with metformin, “there needs to be an improved evidence base and outcome data, before this can be recommended as a strategy,” the authors wrote.
Writing in the MJA, the authors said there were particular barriers to managing T2DM in Indigenous children in remote settings, including poor school attendance and limited access to health services and telecommunications. There was also the potential shame of diagnosis, poor acceptance of diagnosis, and many competing health needs.
MJA 2012; doi: 10.5694/mja12.10036
Indigenous children over the age of 10 who have risk factors for type 2 diabetes should be screened, new recommendations say.
The panel of clinicians, researchers and policymakers authoring the recommendations said the prevalence of T2DM among Indigenous children and teens was not only much greater than among the non-Indigenous but it was also rising, and those in remote areas were at an even greater risk.
Most young Indigenous people with T2DM were asymptomatic at diagnosis, had a family history of diabetes, were overweight and may have signs of hyperinsulinism, the authors said.
They recommended screening for Indigenous children over ten with any of these symptoms, or who showed signs of insulin resistance or dyslipidaemia, had received psychotropic therapy or who had been...