Type 2 diabetes

Call to screen Indigenous children for T2DM as rates soar

The problem of type 2 diabetes in Indigenous children is so serious that screening should be rolled out in schools, a leading endocrinologist says.

According to AIHW statistics from 2014 the incidence of type 2 diabetes (T2DM) is eight times higher in Aboriginal and Torres Strait Islander children aged 10-14 years compared to peers of the same age in the general population.

But Baker Institute’s director of clinical diabetes Associate Professor Neale Cohen says as most children are asymptomatic at diagnosis, cases are being missed and the true rate is likely to be higher.

“There is a real lack of data in this young population and I fear it (the rate) may even be worse than we think,” Professor Cohen told the limbic.

In 2012 along with a group of diabetes experts Professor Cohen recommended targeted screening of Indigenous children aged over 10 but found the documented burden of disease “does not justify population screening”.

Writing in the MJA, the group convened by Baker IDI Heart and Diabetes Institute recommended screening by random blood glucose level testing in a clinical setting for children with risk factors including obesity, a family history of diabetes, signs of insulin resistance, dyslipidaemia and exposure to diabetes in utero.

Five years on, Professor Neale Cohen claims the case for population screening in schools is now compelling.

Early-onset T2DM is associated with higher morbidity than early T1DM as well as a  higher incidence of cardiovascular disease, renal disease and death.

“It’s become a significant public health issue that threatens to derail efforts to close the gap in life expectancy between Indigenous and non-Indigenous Australians,”  Professor Cohen said.

“Untreated, this disease can lead to irreparable damage, which means these children are associated with the worst prognosis in the long term”.

Professor Cohen said the situation was at a point where we should consider screening Indigenous children in a school setting, ideally by testing HbA1c levels.

“Fasting glucose would be challenging if not impossible as would a GTT (glucose tolerance test),” he added.

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