HJAR Jan/Feb 2024

40 JAN / FEB 2024 I  HEALTHCARE JOURNAL OF ARKANSAS ADH CORNER COLUMN CHILDREN’S HEALTH ADVANCEMENTS in the diagnosis and treatment of pediatric patients with diabe- tes are making it possible to delay the on- set of symptomatic diabetes and improving the ability of caregivers to help manage this chronic disease. Most exciting is that delaying the onset of the disease is feasible for patients with either Type 1 or Type 2 diabetes. Behavior management and exercise have been used to prevent prediabetes from becoming full- blown Type 2 diabetes, but, historically, there were no corresponding options for patients with Type 1 diabetes. New FDA-approved drugs can extend that reprieve to presymp- tomatic Type 1 diabetes patients for up to two years. Early and accurate screening essential in delaying onset The hemoglobin A1C test remains the standard for identifying Type 2 diabetes in patients. Type 2 diabetes progresses from insulin resistance to prediabetes, to Type 2 diabetes, to Type 2 diabetes with vascular complications. Diet and exercise regimens and medications can reliably prevent the progression from one stage to the next. The medical community’s adoption of a classification system for stages of Type 1 diabetes has expanded opportunities for research trials and interventions that can delay the onset of that formof the disease.The recognized stages of Type 1 Diabetes include: Stage 1: The presence of two or more dia- betes-related autoantibodies marks Stage 1 of the disease. Individuals are asymptomatic, and blood sugars are normal, but the immune system has begun attacking insulin-produc- ing beta cells. Stage 2: An increased loss of beta cells gen- erates abnormal blood sugar levels, but many individuals remain asymptomatic. Stage 3: The significant loss of beta cells produces symptoms like polyuria, polydipsia, weight loss, blurred vision, and fatigue. This stage was previously considered the begin- ning of Type 1 diabetes. Research shows children progress from one stage to the next more quickly than Jurhee Freese, MD Pediatric Endocrinologist Arkansas Children’s A Pathway Forward in Diabetes Care for Pediatric Patients: FROM DELAYING ONSET TO CAREGIVER EDUCATION