| Abstract: |
Due to the current epidemic of obesity among children and adolescents, physicians can logically expect to encounter increasing numbers of young patients presenting initially with signs and symptoms associated with uncontrolled hyperglycemia (high blood glucose) and relatively advanced cases of diabetes. This article reviews the risk factors, diagnosis, and treatment of type 2 diabetes in children and adolescents. The authors use the case of a young adolescent (a 13-year-old Hispanic girl) with multiple risk factors for type 2 diabetes. The authors first discuss the role of family history and genetics, insulin resistance, criteria for diagnosis of diabetes, and classification of diabetes. One section covers some of the issues to consider when initiating a therapeutic regimen for this patient population, including illness severity and stage, anticipated adherence, developmental stage, and family socioeconomic status and level of support. Lifestyle changes that involve the entire family, including detailed attention to diet and exercise, constitute the foundation of an effective treatment plan. The authors also discuss drug therapy, including the use of insulin. Health care providers are encouraged to match a younger patient's level of commitment with an appropriately designed therapy, considering any possibilities to increase the likelihood of adherence and compliance to therapy. 2 figures. 27 references. |