| Abstract: |
Type 2 diabetes is emerging as an important disease in children and adolescents, accounting for 8 to 45 percent of new childhood diabetes. This article provides an update from the National Diabetes Education Program (NDEP) on the management of type 2 diabetes in youth. High-risk youths older than 10 years would be those who have a body mass index (BMI) greater than the 85th percentile for age and sex plus two additional risk factors such as family history, high-risk ethnicity, acanthosis nigricans, polycystic ovary syndrome, hypertension, or dyslipidemia. The authors stress that reducing overweight and impaired glucose tolerance with increased physical activity and healthier eating habits may help prevent or delay the development of type 2 diabetes in high-risk youths. Although population-based screening of high-risk youths is not recommended, physicians are encouraged to closely monitor these patients because early diagnosis is beneficial. Young patients who are diagnosed with diabetes need to received self-management education, behavior interventions to promote healthy eating and physical activity, appropriate drug therapy for hyperglycemia––usually metformin and insulin––and treatment of any comorbidities. A final section briefly describes ongoing clinical studies of youths with diabetes. The article includes a side bar that summarizes the related key recommendations for practice. 6 tables. 25 references. |