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AAP Issues Guidelines for Management of Type 2 Diabetes in Children

First recommendations for this age group (Jan. 28)

According to the American Academy of Pediatrics (AAP), the prevalence of childhood obesity has increased dramatically in North America during the past three decades, leading to a host of health problems — including type 2 diabetes — that formerly affected only adults.

To assist physicians in caring for this population, the AAP has issued a new set of guidelines to provide evidence-based recommendations on managing type 2 diabetes in children aged 10 to 18 years. The guidelines — the first of their kind for this age group — were published in the February 2013 issue of Pediatrics and were released online Jan. 28.

The guidelines recommend beginning treatment with insulin at the time of diagnosis in all patients who are ketotic or in ketoacidosis, who are 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 new guidelines also include recommendations for monitoring pediatric patients’ glycemic control and for implementing insulin regimens, as well as diet and physical activity recommendations.

Source: AAP; January 28, 2013.

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