title: Type 2 diabetes in children: oxymoron or medical metamorphosis?
abstract: The full public health effects of the new epidemic of obesity and diabetes in children and adolescents may not be known for many years but are certain to be substantial. Diagnosed diabetes, which is present in only 4.2% of the US population, along with its consequences, already represents approximately 19% of the total personal healthcare expenditures in this country. Between 1997 and 2002, the estimated direct medical cost of diabetes increased from 44 billion dollars to 92 billion dollars, a staggering increase of 8 billion dollars a year. In 2002, diabetes annual costs per capita rose by more than 30% to 13,243 dollars per person, compared with the average annual health care costs for persons without diabetes of 2560.92 dollars. An estimate from the CDC indicates that approximately one-third of children born in 2000 will develop diabetes at some time in their life, and nearly one-half of all Hispanic children born in 2000 will develop diabetes. As type 2 diabetes is being diagnosed at an earlier age, more young people can expect to live many more years with diabetes and its complications, adding even further to this already enormous health burden. An appropriate starting place is recognition of the magnitude of the problem by physicians, politicians, public health policy makers, and other healthcare workers. An aggressive approach to management of diabetes must begin well before the appearance of cardiovascular, eye, renal, and other complications of diabetes appear, and even before obesity leads to diabetes. Currently, physicians and other healthcare workers are poorly reimbursed for management of obesity, for diabetes education, and for ongoing telephone contact with diabetic patients and families, essential for optimal diabetes management. National policies and priorities must be readjusted to emphasize prevention, rather than crisis management, if we are to avoid a catastrophic public health crisis within the next several decades.
authors.affiliation: Section of Diabetes and Endocrinology, Department of Pediatrics, University of Oklahoma Health Science Center, Oklahoma City 73104, USA. kenneth-copeland@ouhsc.edu
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Copeland
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Chalmers
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000628:therapy; D004032:Diet; D004327:Drinking Behavior; D015438:Health Behavior; D006801:Humans; D009765:Obesity / Q000150:complications*; D012307:Risk Factors