Risk reduction for T2DM

Question 1

What are some of the risk factors and causes of T2DM

Answer 1

Multifactorial:
Genetic markers - 4 identified
Gestational diabetes
Obesity
Physical inactivity
Family history

Question 2

What are the physical signs of insulin resistance and the metabolic syndrome?

Answer 2

Acanthuses Nigrans
PCOS - insulin resistance
HTN
Dyslipidemia
Steatohepatitis

Question 3

Does insulin resistance and the metabolic syndrome cause T2DM?

Answer 3

No.

They are associated with glucose intolerance and early onset T2DM

Question 4

Does screening children for T2DM work?

Answer 4

There is no evidence to support that screening in children works. There are two Canadian studies, and no new cases of T2DM were found.
At present there is insufficient evidence to support screening in aboriginal children. One of the options is ‘opportunistic’ screening of high risk individuals

Question 5

Who is considered high risk and thus should be screened?

Answer 5

Need all off the following: aboriginal, BMI > 85 percentile, and age >10
+
One of the following: sedentary lifestyle, moms with GDM, FHx (1st or 2nd degree relative), acanthuses ingrains, dyslipidemia, HTN, PCOS

Question 6

How do you screen?

Answer 6

Fasting BG - > 7.0
Random BG > 11.1
OGTT

Question 7

Does breast feeding have a role in preventing T2DM?

Answer 7

Yes because it has been shown to decrease obesity

Question 8

How much activity should kids get?

Answer 8

Daily activity of 60-90 minutes
1/3 of activity should involve moderate intensity
All schools should have 30 minutes of daily activity (at least)

Question 9

How much passive activity should a kid do in 1 day?

Answer 9

1.5 - 2 h per day