Mass screening of all children and teens for type 2 diabetes is not justified, says a systematic review ordered by the USPSTF. Screening makes sense only for high-risk children. That holds even as childhood obesity rises and type 2 diabetes grows more common in kids and youth.
Childhood obesity is common. So more and more children show signs of metabolic disease. Type 2 diabetes has also been rising in kids and youth. That raises a question. Should all kids and youth get regular checks for type 2 diabetes? Finding and treating it early is tied to better outcomes. But a systematic review ordered by USPSTF says screening for type 2 diabetes is only justified in high-risk children. Mass screening is not.
First, let us be clear. The US Preventive Services Task Force (USPSTF) advice is for type 2 diabetes. That type is mostly found in obese adults. Type 1 diabetes is mainly found in kids and teens. About 90% of all those living with diabetes in the US have type 2 diabetes. It is caused by insulin resistance, and it is a lifestyle disease. It takes years to develop in most cases. So it is rarely found in kids or youth. But it is common in older adults, affecting more than 10% of the population.
Kids are more likely to get type 1 diabetes. It is an autoimmune disease. Immune cells destroy the beta cells in the pancreas that make insulin. Right now, about 210,000 kids live with diabetes, and most of them have type 1 diabetes. The problem is that type 2 diabetes is also rising in kids. Higher obesity rates and more metabolic disease are driving it.
So out of 210,000 kids living with diabetes, about 23,000 have type 2 diabetes. These numbers are not massive, but they are significant. This raises one key question. Should doctors regularly screen kids and youth for type 2 diabetes? Metabolic problems like dyslipidemia, non-alcoholic fatty liver disease, and even high blood pressure are rising in children and young adults. The COVID-19 pandemic made the trend even worse.
For families dealing with diabetic neuropathy, seek out specialized treatment. A number of doctors and clinics focus on diabetic neuropathy treatment, including nerve conduction studies, pain management, and physical therapy. Good treatment for diabetic neuropathy can ease symptoms and prevent more nerve damage. If you or a loved one has diabetic neuropathy, reach out to a qualified doctor. Talk through treatment options and find the right fit for your needs.
Type 2 diabetes in the young is also more harmful. It is more likely to move fast. It causes long-term problems like heart and blood vessel disease, chronic kidney disease, and so on. However, the latest study by USPSTF says that there is no need for regular screening for type 2 diabetes in kids and youth, as the distress caused by this kind of screening cannot yet be justified. In 2022, USPSTF ordered a systematic review to weigh the harms and benefits of such screening. They wanted to know if regular screening for type 2 diabetes is justified in kids or youth who do not have many symptoms.
They concluded that screening should only be done in high-risk kids and youth. That means those with some symptoms who are grossly overweight. There is no reason for mass screening for type 2 diabetes in this young group. It would do more harm than good. The study also gave other advice on early diagnosis and care. For example, there are more than 30 drugs to treat type 2 diabetes. Only three are approved for use in children: metformin, insulin, and liraglutide.
Among these drugs, metformin is good for managing diabetes in young people. But it is not approved to stop prediabetes from turning into diabetes in the young. The study also found that intensive lifestyle change works less well in children and teens than in adults. That is the method of choice for early diabetes.
Even so, the study says prediabetes and mild type 2 diabetes in children should be managed with weight loss, diet, and more physical activity. Lifestyle changes like weight loss work less well in children. Still, health experts say it is the safest and most effective way to slow type 2 diabetes in children. To sum up, USPSTF says screening is only good for high-risk children. That means those who are grossly obese and show other signs of insulin resistance, like acanthosis nigricans or polycystic ovary syndrome.
Yes, and it is becoming more common as childhood obesity rises. About 210,000 kids in the US live with diabetes. Most have type 1, an autoimmune disease. In it, immune cells destroy the cells of the pancreas that make insulin. About 23,000 have type 2, the insulin-resistance form. It usually takes years to develop and is far more common in adults.
High-risk children only. That means kids who are grossly overweight and have some symptoms. It also means kids who show other signs of insulin resistance, such as acanthosis nigricans or polycystic ovary syndrome. The review ordered by the USPSTF found no reason to screen every child and teen who has no symptoms.
Because the review found mass screening would do more harm than good. Testing upsets children without symptoms. The benefit cannot yet justify that distress, even though early diagnosis and treatment are tied to better outcomes. Screening pays off where the risk is already high, not across all kids.
Prediabetes and mild type 2 diabetes in children are managed with weight loss, diet changes and more physical activity. Lifestyle change works less well in kids than in adults. Yet it is still the safest and most effective way to slow the disease. Of the more than 30 drugs for type 2 diabetes, only metformin, insulin and liraglutide are approved for children.
Yes. Type 2 diabetes that starts in youth tends to move faster than the adult form. It leads sooner to long-term problems such as cardiovascular (heart and blood vessel) disease and chronic kidney disease. That is why a child with clear risk factors should be tested, not just watched. Those risks include severe obesity or signs of insulin resistance.
The US jails more people than any other country. A new study shows very high cancer rates in this group. It appears that 30% of incarcerated adults die of cancer. They are also more likely to get gut (gastrointestinal) cancer than other groups. So researchers say incarcerated adults need better access to cancer screening to catch it early. People who have been to prison should also know they face a higher cancer risk.
The US has the most people in prison at any given time, with more than 2 million held. That means several million people have spent at least some time locked up. Not all of them are there for serious crimes. Studies suggest people who have spent time in prison face a higher risk of some health conditions. These include complex regional pain syndrome and chronic pain.
These numbers are huge. So it is vital to understand the health risks in this group. Sadly, it is also one of the most neglected groups. But now a new study shows that incarcerated people are at a much greater risk of dying from cancer than people who were never imprisoned. In fact, cancer is the leading cause of death in people who have spent time in prison. Studies suggest almost 30% of all deaths in incarcerated people are from cancer. That is far higher than in the general population.
The problem is that incarcerated people are more likely to die of cancer even when they are out of prison. To confirm this, researchers studied data from the cancer registry. They looked at all cancer cases from 2005 to 2016. Cancer was almost 50% more common in this group. And they were almost twice as likely to die from invasive cancer as other people. Most people do not think of this group as high-risk for cancer. They think of infections, substance abuse, metabolic disorders, and other problems. But it appears that even some time in prison raises cancer risk a lot.
There may be many reasons for the higher cancer risk and lower survival. It could be high stress, poor medical care, bad diet, and more. Being locked up also means less movement and fewer comforts. Studies also show the cancer pattern is different in incarcerated people. They are most likely to get cancer of the gut, followed by lung, prostate, leukemia, and lymphoma.
Some reasons are easy to see. In prison, there is no access to high-quality medical care. That means chronic health problems are poorly treated. It also means cancer and other diseases are diagnosed late. Incarcerated people may also miss proper treatment and comfort (palliative) care. That may explain the much higher cancer death rate in this group.
The truth is that researchers still do not fully know why incarcerated people get more cancer. So researchers say their study also shows why we need transition centers for people leaving prison. These would remove some barriers to catching cancer early. They would also ensure better primary care, steady food, and jobs. And they would help people rejoin society.
Researchers say cancer screening must be part of primary care for people just released from detention. These findings matter most for policymakers, who need to make big changes in the prison system. Cancer is now the leading cause of disease and death in this group.
Too often, it is found late and treated poorly. Prisons lack high-quality medical care. So chronic conditions go undertreated and cancer is diagnosed late. Incarcerated people may also miss proper cancer treatment and comfort care. Put together, those gaps help explain why cancer kills this group at a much higher rate than people who were never imprisoned.
Cancer. It is the leading cause of death in people who have spent time in prison. It accounts for almost 30% of all deaths in incarcerated people. That share is much higher than in the general population. Many people assume infections, substance abuse or metabolic disorders are the bigger threat to this group. Cancer is the one that kills most often.
Cancers of the gut lead, followed by lung cancer, prostate cancer, leukemia and lymphoma. That pattern differs from the general population. And it matters for screening. A doctor caring for someone who has been in prison should know which cancers to look for first.
Yes. Incarcerated people are more likely to die of cancer even when they are out of prison. Registry data on cancer cases from 2005 to 2016 showed cancer almost 50% more common in this group. They had nearly twice the risk of dying from invasive cancer. Researchers want cancer screening built into primary care for people just released. They also want transition centers that remove barriers to early diagnosis.
Researchers do not fully know yet. Likely drivers include high stress, poor medical care, poor diet, and less movement while locked up. Late diagnosis once cancer starts adds to it. Even a short time in prison seems to raise cancer risk a lot. So anyone who has been in prison should know about the higher risk and ask about screening.
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