Children and Adolescents Diagnosed with Type 2 Diabetes Mellitus. Part 2
The emerging population of youth diagnosed with type 2 diabetes in the United States, particularly among certain ethnic groups, will require intervention programs on a community level to address the specific needs of this growing population. At present, educational programs and youth/family camps for children and adolescents diagnosed with type 2 diabetes are extremely limited or unavailable. Prevention programs for this population will need to be culturally appropriate, focus on family involvement, and examine existing lifestyle and nutrition behaviors to increase quality of life and decrease some of the preventable health risks associated with this disease. This exploratory study was designed to ascertain the characteristics and perceived needs of youths with type 2 diabetes so that future programs could be developed and implemented.
Qualitative research methods were utilized to gather information on the characteristics and perceived needs of children and adolescents diagnosed with type 2 diabetes in Santa Clara County. Fourteen youth between the ages of 10 and 18 years diagnosed with type 2 diabetes and their parents/guardians were surveyed at the Kaiser Santa Teresa Pediatric Endocrine Clinic in San Jose, California. Following the survey questionnaire, which assessed demographics, anthropometrics, lifestyle behaviors, and nutrition and exercise behaviors, each youth participated in a follow-up interview to obtain qualitative information related to his/her diabetes knowledge, perceptions, and management.
The criteria used at the Pediatric Endocrine Clinic to distinguish the diagnosis of a child or adolescent with type 2 diabetes versus type 1 diabetes included: 1) presence of overweight (BMI ≥ 25.0 < 30.0 kg/m2) or obesity (BMI ≥ 30.0 kg/m2), 2) family history of type 2 diabetes, 3) negative antibody markers for type 1 diabetes including anti-insulin, anti-islet cell, and anti-GAD antibodies, 4) the eventual cessation of exogenous insulin.
The principal investigator, as well as the endocrinologists and nursing staff of the Kaiser Santa Teresa Pediatric Endocrine Clinic, conducted recruitment for the study. Subjects and their parents/guardians were invited to participate in the study during medical check-ups with the endocrinologists or via phone calls by the principal investigator.
Informed written consent was obtained from both parents and youth. Subjects were asked to complete a twenty-minute survey containing questions on demographics, family history, diabetes management, lifestyle behaviors, nutrition behaviors, and diabetes risk factors. Upon completion of the questionnaires, subjects were asked if they would participate in a short 15-minute follow-up interview to answer additional questions about their diabetes management. Both the survey questionnaires and follow-up interviews took place in a private office at the Kaiser Santa Teresa Pediatric Endocrine Clinic. To ensure confidentiality of subjects, the questionnaires and follow-up interviews were not associated with any personally identifying information and were identified only by study code. Approval for the study was obtained from the Kaiser Permanente Institutional Review Board, the Kaiser Permanente Central Research Committee, and the San Jose State University Human Subjects Institutional Review Board.