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I recently read an article on New York Time’s Wellness Blog about Type 2 DM and Children.   We all know that the incidence of Type II DM is increasing in this population and this article sought out to find the best medical treatment to control it.  The conclusion: high failure rates in all groups.  This is not what we want to hear!  You can read the article yourself but two interesting pieces of information (underlined) from the article struck me, “obesity-linked diabetes in children resists treatment” and “it is harder to treat in children”.  I want to relate this to future problems with LBP and treatment from a physical therapist’s standpoint. 

Now if we can’t make changes in the highly plasticity, adaptable, versatile adolescent; then how can we help the indolent, overweight, inflexible average adult?

Well, how does this relate to our treatment of LBP?

It has everything to do with LBP.  Both have no cure.  LBP can be treated via a self-manageable, self-controlled and self-cared approach.  So can II DM.  We can educate all day long on physical activity and diet with little adherence.  If medication is not working with treatment of II DM currently in adolescents and they are the least active generation ever, what will happen in the future?  

This is an unfortunate disease that affects all systems and definitely a public health concern.  II DM is increasing in adolescents, bottom line.  I would suggest that LBP will increase in the future as II DM increases.  I don’t feel like I am going out on a limb with this statement here. If adolescents are getting more and more back pain complaints at a younger age, this will affect us in the future. We know the best predictor of future back pain is prior back pain.  

II DM is due to lifestyle choices such as limited physical activity and poor diet.  There are other factors, but can’t go wrong with this claim.  If we can’t get these adolescents to change their lifestyle choices for a disease that can cause blindness, nerve damage, amputation, system(s) shutdown, how will they respond to our treatments for low back pain in the future that simply keeps them from doing what they don’t want to do, be active?  Will they be resistant and harder to treat than our current adult low back pain patients now?

Do you think a physically active, educational, movement-based approach will work in the future?  Tough to say.  Time will tell. 



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