Interventions for Children With Type 2 Diabetes and Their Parents

Limited research has been conducted on interventions for children and adolescents with type 2 diabetes. Indeed, the majority of research has been conducted with adults. However, given the connection between obesity and type 2 diabetes, preventive interventions for children and adolescents are becoming more common. These interventions focus on increasing dietary knowledge and promoting physical activity to help reduce the likelihood of type 2 diabetes. For example, a 1-year school-based intervention for students in grades 3-5 in Canada produced gains in dietary knowledge, overall health knowledge, and dietary self-efficacy (Saksvig et al. 2005). Similar interventions are described elsewhere (S.M. Davis et al. 1999; Macaulay et al. 1997). Other interventions that target adults diagnosed with type 2 diabetes have focused on group education programs (Davies et al. 2008) and self-management approaches (Thoolen et al. 2007).

Pharmacological interventions, such as using metformin, have also been shown to be effective. The Diabetes Prevention Program (Knowler et al. 2002) found that for high-risk individuals, met-formin reduced the risk of developing diabetes by 31% when compared with the placebo condition after a mean follow-up of almost 3 years. Although that study was the largest randomized medication trial to date, other studies have shown similar effectiveness (Ramachandran et al. 2006).

The largest treatment trial for type 2 diabetes conducted to date is under way in the United States. Sponsored by the National Institutes of Health, the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TOD2AY) trial will examine three different treatments—metformin plus placebo, metformin plus rosiglitazone, and metformin plus lifestyle change—in a sample of 750 youth who are obese. Hopefully, the results of this study will better inform treatment recommendations for youth with type 2 diabetes.

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