Primary prevention
Prevention of type 2 diabetes mellitus (T2DM) in children involves interventions to prevent the development of obesity or to correct obesity before the development of insulin resistance and comorbidities.[50] Behaviour-changing interventions that incorporate diet and physical activity may be beneficial in achieving small, short-term reductions in body mass index.[51]
There are differences between populations as to how predictive impaired glucose tolerance (IGT) is for the development of T2DM. In Europe, IGT is not seen as highly predictive of progression to diabetes in the short-to-medium term.[52] However, in those with black African ancestry, IGT is seen as more predictive of developing diabetes.[53] Intensive lifestyle modifications, including 5% to 10% weight loss, are recommended for these children to prevent the development of T2DM.
Secondary prevention
Identification and targeting of lifestyle modifications for children at risk for the development of type 2 diabetes mellitus can delay the onset of disease.[107]
Early identification and aggressive treatment of complications such as inadequate glycaemic control, hypertension, dyslipidaemia, and albuminuria may reduce premature morbidity and mortality.
Diabetes education and lifestyle modifications for the entire family, and not just the patient, may be beneficial in increasing compliance and preventing long-term complications.
Smoking cessation counselling for older children and adolescents should be included as a routine component of diabetes care to prevent long-term cardiovascular complications. Note that electronic cigarettes are also discouraged.[1]
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