Pediatrics Medical News about type 2 diabetes; children

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Children get type 2 diabetes too
Australian Family Physician, 09/09/09

Phillips J et al. – Type 2 diabetes is the consequence of a complex interaction between genes and the environment in a susceptible individual. Children with T2DM are generally overweight, often with central adiposity. Having one or more parents with T2DM gives offspring up to an 80% chance of developing T2DM. At risk children and adolescents should be screened for T2DM. It is important to check the glutamic acid decarboxylase (GAD) antibody to exclude type 1 diabetes. Management is team based and team members include the general practitioner, diabetes educator, dietician and endocrinologist. Goals include achieving and maintaining normoglycaemia, weight reduction and increased physical activity. Lifestyle modification alone may control minor hyperglycaemia and metformin can be added to control moderate hyperglycaemia. In severe hypoglycaemia, insulin may be required initially to achieve normoglycaemia and can be phased out and metformin phased in later. Little is known about factors affecting complication risk in children and adolescents with T2DM but they essentially have a ‘double whammy’ of diabetes and the metabolic syndrome and are likely to develop macrovascular complications much earlier than adults who develop T2DM.

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