Childhood Diabetes Type 2 Hilary Ortega Chamberlain College of Nursing NR 506 Policy

In my experience there have been an increasing amount of younger patients experiencing largely environmentally influenced conditions such as hypertension, coronary artery disease, diabetes mellitus type 2 or T2DM, obesity, stroke, and peripheral vascular disease (Hernandez, Marcus, Hirst, Faith, Goldberg, & Treviño, 2014). Although all of these disorders demand attention my policy priority issue will focus on the primary introduction of lifestyle modifications to combat new onset T2DM in children and young adults. Habits formed during the inquisitive years of childhood will likely continue into adulthood (“Setting Kids”, 2014). Thus the assessment of childhood and parent diet, activity, and perspective on a healthy lifestyle will be the initial step toward improved outcomes for children and adults alike. Due to the multiple conditions associated with diabetes mellitus type 2 a reduction of the occurrence in the formative years within the lifespan will contribute to a healthier society (Hernandez et al., 2014). Key Points
Usually when a child is diagnosed with diabetes it is type 1 or insulin dependent diabetes however type two diabetes, formally known as adult-onset diabetes, is currently increasing (Forbes, Fraser, Downs, Storey, Plotnikoff, Raine, & ... McCargar, 2013). Factors associated with the diagnosis are consistent with obesity, lack of exercise, and consuming foods high in sugar content and low in nutritional value, and lack of sleep (Forbes et al., 2013). The American Diabetes Association recommends measuring a child’s fasting plasma glucose FPG for those at risk for T2DM (Forbes et al., 2013). Obesity is one of the risk factors for which screening is necessary (Forbes et al., 2013). Another key area for improvement is diet at school and at home. Public schools are an opportunity to make healthy eating habits a norm for children and adolescents. Availability of healthy choices, lack of unhealthy foods, exercise classes, and screening methods may be done at school. Standard tests and physical examinations are already done for vision, hearing, and scoliosis, perhaps a glucose screening would provide a opportunity to catch early indications of the diabetes in children. Parents should be educated and assessed for possible habits which aid in poor diet in children. Schools can be the leading initiative to screen, educate, provide referrals, and track the progress of children at risk for diabetes. As a greater number of the population become afflicted with complications at younger ages, insured and noninsured patients must receive treatment which result in greater deficit. Programs such as Medicare and Medicaid are directly impacted which are reliant on government funding. Empirical Evidence
Diabetes mellitus describes a metabolic disease which results in elevated blood glucose levels. Uncontrolled high glucose levels can lead to increased morbidity and premature mortality (Hernandez et al., 2014). Diabetes is the 7th cause of death in the US is significantly correletated with other causes of death such as stroke or ischemic heart conditions (Hernandez et al., 2014). An increase in visceral rather than subcutaneous fat correlate obesity with insulin resistance (Hernandez et al., 2014). Obesity is defined as weights within the 85th and 95th percentile. Other factors such as family incidence will increase the risk of children developing a type two diabetes and should be included as a screening tool. Those diagnosed with T2DM 92% are insulin resistant which is associated with metabolic syndrome (Hernandez et al., 2014). Clinical features include central trunk obesity, high insulin levels, hypertension, high lipids, arthrosclerosis, and glucose intolerance (Hernandez et al., 2014) . Beta cells of the pancreas respond to high levels of circulating blood glucose by an