The American Academy of Pediatrics has issued a set of guidelines to provide evidence-based recommendations on managing type 2 diabetes in children ages 10 to 18.
The guidelines are the first of their kind for this age group, according to an AAP news release. Over the past three decades, the prevalence of childhood obesity has increased dramatically in North America, ushering a host of health problems, including type 2 diabetes, that formerly afflicted only adults.
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, the guidelines recommend beginning treatment with insulin at the time of diagnosis in all patients who are ketotic or in ketoacidosis, markedly hyperglycemic or in whom the distinction between type 1 and type 2 diabetes is not clear.
In all others, metformin is recommended as first-line therapy along with a lifestyle modification program that includes nutrition and physical activity.
The guidelines also include recommendations for monitoring pediatric patients glycemic control, implementing insulin regimens, and diet and physical activity.
The guidelines appear in the February issue of the journal Pediatrics and are available as a PDF at http://pediatrics.aappublications.org/content/early/2013/01/23/peds.2012-3494.full.pdf. An accompanying technical report is available as a PDF at http://pediatrics.aappublications.org/content/early/2013/01/23/peds.2012-3496.full.pdf.