Sweeney, N. M., Stewart, C., Gaines, R., Lewis, M., Rockett, J., & Leivas, T. (2007). Journal of Pediatric Nursing, 22, 432-439.

Much has been published in the scientific and lay literature about the dramatic rise in childhood obesity. There is also the conviction that there is an "epidemic" of type 2 diabetes in children, yet minimal data are available on the incidence and prevalence of the disease in pediatrics. Because type 2 diabetes, unlike type 1 diabetes, can be undetected for some time, there is a question of whether children, particularly those from racial groups at risk, should be screened for type 2 diabetes.

Body mass index (BMI), waist circumference, and random blood glucose levels were measured in 280 white and Hispanic fifth-grade children. Survey data were also obtained on sugary beverage consumption and activity. Hispanic children had a significantly higher mean BMI percentile, waist circumference, and soda consumption and reported less activity. Although 44% of the children screened had a BMI > the 85th percentile, no children were found to have type 2 diabetes. It is critical to screen children for obesity and educate children and parents about the importance of a healthy diet and daily activity. As nurses, however, we must understand that there are racial and socioeconomic disparities in childhood obesity, as demonstrated in this study and others. Public health issues impede healthy diet and exercise, such as lack of time to prepare family meals and the unavailability of safe locations to play outdoors. Pediatric nurses should lobby for policy changes to improve the environment of all children. This study also demonstrates that understanding the epidemiology of a disease is crucial. It seems that the prevalence of type 2 diabetes in fifth-grade children is too low to merit invasive screening.

Terri H. Lipman