The American Academy of Pediatrics (AAP) recently issued guidelines to provide evidence-based recommendations on managing type 2 diabetes in children aged 10 to 18. The guidelines are the first of their kind for this age group.   

The recommendations suggest integrating lifestyle modifications, including diet and exercise, in concert with medication rather than as an isolated initial treatment approach. Specifically, clinicians should encourage patients to engage in moderate-to-vigorous exercise for at least 60 minutes daily and to limit nonacademic “screen time” to less than 2 hours a day. "Physical activity is an integral part of weight management for prevention and treatment of T2DM," write the authors. They suggest that when prescribing physical exercise, clinicians should be sensitive to the needs of children, adolescents, and their families. Noting that routine, organized exercise may be beyond the family's logistical and/or financial means, it is "most helpful to recommend an individualized approach that can be incorporated into the daily routine, is tailored to the patients' physical abilities and preferences, and recognizes the families' circumstance."

The guidelines also call for additional research. In particular the authors recommend studies that delineate whether using lifestyle options without medication is a reliable first step in treating selected children with type 2 diabetes, explore the efficacy of school and clinic-based diet and physical activity interventions to prevent and manage pediatric type 2 diabetes, and investigate the association between increased "screen time" and reduced physical activity with respect to type 2 diabetes risk factors.

The guidelines were written in consultation with the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians, and the Academy of Nutrition and Dietetics.

Marilyn Mount, PT, a prolific member of the Ohio physical therapy community, who passed away last August, has left a bequest of $32,000 to the Foundation for Physical Therapy, which will be designated toward the Florence P. Kendall Doctoral Scholarship Fund.

Mount was the recipient of numerous awards and accolades for her lifelong service to the physical therapy profession, some of which include: from the Ohio Chapter, Physical Therapist of the Year (1997), Outstanding Service Award from the Northeast District (2003), and Meritorious Service Award (2008); the Viking Shield Award from Cleveland State University's Physical Therapy Program (2011); and the Crains Cleveland Business Health Care Heroes Award for Allied Health (2012).

Read more about Mount in the Foundation's press release.

Last week, the Department of Education's Office for Civil Rights issued guidance clarifying school districts' existing legal obligations to provide equal access to extracurricular athletic activities to students with disabilities. In addition to explaining those legal obligations, the guidance urges school districts to work with community organizations to increase athletic opportunities for students with disabilities, such as opportunities outside of the existing extracurricular athletic program.

Students with disabilities have the right, under Section 504 of the Rehabilitation Act, to equal opportunity to participate in their schools' extracurricular activities. A 2010 report by the US Government Accountability Office found that many students with disabilities are not afforded an equal opportunity to participate in athletics and therefore may not have equitable access to the health and social benefits of athletic participation.

"Sports can provide invaluable lessons in discipline, selflessness, passion, and courage, and this guidance will help schools ensure that students with disabilities have an equal opportunity to benefit from the life lessons they can learn on the playing field or on the court," said Education Secretary Arne Duncan.

The guidance letter provides examples of the types of reasonable modifications that schools may be required to make to existing policies, practices, or procedures for students with intellectual, developmental, physical, or any other type of disability. Examples of such modifications include:

• The allowance of a visual cue alongside a starter pistol to allow a student with a hearing impairment who is fast enough to qualify for the track team the opportunity to compete.
• The waiver of a rule requiring the "two-hand touch" finish in swim events so that a swimmer with 1 arm with the requisite ability can participate at swim meets.

The guidance also notes that the law does not require that a student with a disability be allowed to participate in any selective or competitive program offered by a school district, on the condition that the selection or competition criteria are not discriminatory.