Recommendations suggest integration of lifestyle modifications together with medication
MONDAY, Jan. 28 (HealthDay News) -- New guidelines recommend lifestyle modifications together with medications for children and adolescents diagnosed with type 2 diabetes mellitus (T2DM); these clinical practice guidelines from the American Academy of Pediatrics (AAP) have been published online Jan. 28 in Pediatrics.
Kenneth C. Copeland, M.D., and colleagues from the AAP Subcommittee on Management of T2DM in Children and Adolescents, with the support of the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians, and the Academy of Nutrition and Dietetics, reviewed the evidence to produce recommendations on managing 10- to 18-year-old patients diagnosed with T2DM.
According to the report, management modalities that have been shown to affect clinical outcome in this population are recommended. In situations where insulin or metformin is the preferred first-line treatment option, lifestyle modifications (diet and exercise) should be integrated together with medication. Guidelines are included for the frequency for monitoring hemoglobin A1c and finger-stick blood glucose concentrations. When treatment goals are not met or when therapy with insulin is initiated, providers should consult experts trained in the care of children and adolescents with T2DM. If a pediatrician feels that they lack adequate training, a referral to a pediatric medical subspecialist should be made. If a pediatric medical subspecialist makes the T2DM diagnosis, the primary care clinician should develop a comanagement strategy to ensure that the child continues to receive appropriate care consistent with a medical home model.
"The rapid emergence of childhood T2DM poses challenges to many physicians who find themselves generally ill-equipped to treat adult diseases encountered in children," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
Abstract (http://pediatrics.aappublications.org/content/early/2013/01/23/peds.2012-3494.abstract )Full Text (http://pediatrics.aappublications.org/content/early/2013/01/23/peds.2012-3494.full.pdf+html )