ADA’s Position on the Evaluation and Management of Type 2 Diabetes in Youth. December 11, 2018

There has been an increasing amount of youth-onset type 2 diabetes diagnoses in recent years. Unlike their adult counterparts, youth who have diabetes have comparatively greater insulin resistance as well as an increased rate of beta cell burnout and increased rates of morbidity and mortality. Unfortunately, the research regarding youth-onset diabetes has not kept pace with the recent increases in occurrence. Consequently, the American Diabetes Association (ADA) has issued a position statement that helps to summarize the currently available data into a usable clinical guideline.
 ADA’s Position on the Evaluation and Management of Type 2 Diabetes in Youth
by  Author: Michael Zaccaro, Pharm. D. Candidate 2019, LECOM School of Pharmacy
 http://www.diabetesincontrol.com/adas-position-on-the-evaluation-and-management-of-type-2-diabetes-in-youth/

 Now there is the question, why diagnose of Diabetes type 2 in youth increased?
It is really complicated question.
      Does there are more diabetics children now then it was 100 years ago?
I do not think so. 100 years ago people died, and no diagnose was available why they died. Even in present time there are millions of not diagnosed Diabetics in America.
       Children who were born to diabetics parents one or both have greatest risk to be diabetics. But parents were not treated properly before child was born.Most of them even were not diagnosed with diabetes. The consequence, child was born with diabetes, unhealthy pancreas.
So to prevent diabetes diagnose in children it is better to treat all American population in case new born would be born diabetes-free.
      And finally, why today children diagnosed with diabetes type 2?
The part of diagnostic for diabetes is body weight. Really it is ridiculous to diagnose medical condition according to the gravity of the body.  If our Medical Complex is not familiar with weight issue then I would remain to them. Size of object can be very small, but weight is very high. (see table of elements) And vise versa. So, if one has heavy bones then body would be heavy, regardless of the amount of fat. Water retention is another issue to be added to the weight. But our bathroom scale do not show difference between water and fat. Consequently child would be diagnosed with type 2 diabetes regardless if any reasonable tests.
      Diagnose is only one part of problem. One day I tried to change my diagnose that I am not diabetic type 2 but type 1. Doctor said, what is difference? The treatment is the same. So, I still diabetic type 2. And I take 400 units of insulin right now, and with plus. It is Winter time. Sugar level is higher in Winter then in Summer and Spring.

The ADA recommends that youth who have excess weight or obesity with an additional risk factor (i.e. family history, susceptible race, or signs of insulin resistance) be screened for type 2 diabetes at puberty or the age of 10 (whichever comes first) and then every three years, thereafter, if no diagnosis can be made.

So, if child is fit then child would not be tested on the level of sugar in blood. If child is obese then level of sugar would be in check. If child is fit, there is no need to check level of sugar in blood. So, now is the question, how myth that obesity caused diabetes type 2 was developed? Simple.  Obese population is checked up for level of sugar in blood. These of us who fit had to wait till pounds overtake body. Is this really eating and conduct problem? Or it is medically induced highly profitable medical condition to the human population?

Once a diagnosis is made, metformin is the first-line pharmacotherapy of choice. However, if the patient’s presenting A1C is ≥ 8.5%, then basal insulin should be initiated while metformin is being titrated to an effective dose.

Now there is another question. We are talking about American youth.  They are all go to school. Why level of sugar is so high and still child was not treated for diabetes? A1c>8.5% is really high blood sugar level. Child is all the time hungry, not active. Child is sick. Why child was not diagnosed with diabetes when level of sugar was above A1c > 4.5%. Also when really child would be diagnosed with diabetes if in this case child was presented in screening event. Why there were no test long before that? Was child in any medical clinic? Yes, he or she was in clinic. Then why A1c > 8.5% ?

It should be noted that, aside from insulin and metformin, none of the remaining anti-diabetes medications have been approved for the treatment of youth. Therefore, use of other types of anti-diabetes medications in youth should be done with caution and on a case-by-case basis. Pharmacotherapy should be titrated to an ideal goal A1C of < 7%; however, glycemic goals should be adjusted on a case-by-case basis in order to minimize risk of hypoglycemia.

So, what is the treatment for child if A1c<8.5% ? Insulin must be in taken if sugar is above A1c>8.5%. What if it is less then 8.5%?
There are two ways. Start Metformin, it is protocol. In case of treatment with metformin level of sugar never would be low. It will be go up and up. When the goal achieved and A1c>8.5% finally insulin therapy would be started..... if diabetic is lucky. Usually in stead of Insulin diabetics get some Junk Medicine such as Invokana or Avandia. Medically induced Mortality in Youth.

The ADA recommends cholesterol goals of < 100, > 35, and < 150 mg/dL for LDL, HDL, and triglycerides respectively.

As it is easy to see, every diabetic has high level of cholesterol. Why? Is it diet? Or it is medically induced  highly profitable medical condition? Stop to take Metformin and see how cholesterol would rise or drop. Simple test. Very simple answer. But it is profit. No one will cut profit. So, diabetics must take Metforming and all Junk Medicine medical complex developed.
    In present time children as little one as 2 years old diagnosed with diabetes type 2. They start to carry one profit  for medical complex before they are able to take first step.

via Ravenvoron