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New ADA Program Targets Diabetes Epidemic in Adolescents
The American Diabetes Association (ADA) has launched Wizdom, a diabetes management program targeting adolescents with Type 2 diabetes, announced Lori Adcock, MD, chair of the ADA Youth Project Team, at the associations' 60th Annual Scientific Sessions in San Antonio.
The new program has four components, each of which is designed to appeal to children aged 13 to 15 years old. Wizdom uses a 14-year-old diabetes wizard named Audrey to teach adolescents how to juggle diet and exercise to control their disease. It includes a kit of educational information for children and parents, an interactive Website that positions diabetes management education in an entertaining way, follow-up educational information that promotes a healthy lifestyle and addresses other issues faced by children with diabetes, and parent support.
The kit, which will be distributed free by the ADA to children referred by a physician, contains notebooks for the child and parents to develop a diabetes resource guide; juggling balls representing food, insulin and exercise; and an educational course that uses a storyline in which Audrey mentors an apprentice wizard recently diagnosed with diabetes. Goodies provided include food samples, temporary tattoos, pens, magnets, stickers, and recipe cards. The new Website, Youth Zone, will feature forums for kids and their parents, a list of ADA-supported summer camps, games and puzzles that teach diabetes lessons, snack ideas and more. A parent-to-parent mentor program will be rolled out in 2001.
A physician at Midland Pediatrics Center in Texas, Dr. Adcock says, "We chose to develop the Website to be very graphic, colorful, and interactive, so we can provide children with a lot of easy-to-understand information, but with an added appropriate sense of humor to help ease the overwhelming surprise and difficult adjustment to managing the disease."
Recently, the medical community has noted an alarming rise in obesity and advent of insulin-resistant, or Type 2, diabetes, among adolescents in North America, especially in children of Hispanic and African-American ethnicity, says Dr. Adcock She explained that previously this form of diabetes had only been seen in adults. For example, she notes that last year about 30 percent of the 300 children diagnosed with diabetes at Baylor Medical Center had Type 2, the majority of which were of Hispanic origin.
Commenting on this problem, Sonia Caprio, MD, of Yale University School of Medicine, says, "The fat child is getting fatter. Obesity has doubled in children over the last two decades." Attributing this phenomenon to both genetics and environment, she adds, "Environment is bringing out our bad genes, and we have created this problem."
Dr. Caprio is co-author of a childhood obesity study, presented at the ADA meeting, which noted a marked increase in IGT (impaired glucose tolerance) among both pre-pubertal and pubertal obese children. IGT is a precursor to development of Type 2 diabetes.
Neil White, M.D., lead author of Washington University School of Medicine study on how best to treat this form of diabetes in adolescents, says children with Type 2 diabetes cannot be effectively controlled using conventional diabetic management practices. His group developed an intensive treatment program, which improves diabetes symptoms and controls and slows progression of the disease. Treatment strategies include increasing number of daily insulin injections (three daily), regular blood sugar testing (four times daily), and weekly visits with a physician specialist.
Additionally, all three physicians note that access to physician specialists is still a problem for obese children living in poverty and low-income homes. Although most children now have access to health insurance through government-sponsored health plans, Dr. Adcock points out, "When the diagnosis is obesity, insurance (Medicaid and CHIP--Texas' health-plan for low-income children who do not qualify for Medicaid) does not pay for visits to specialists, because they don't consider it a disease.