2014糖尿病指南: Children & Adolescents-Type 2 Diabetes in Children &

Screening for Type 2 Diabetes and Prediabetes
 

Consider for all children who are overweight* and have ≥2 of any of the following risk factors:

   • Family history of type 2 diabetes in first- or second-degree relative

   • Race/ethnicity†

   • Signs of insulin resistance or conditions associated with insulin resistance‡

   • Maternal history of diabetes or GDM during child’s gestation

Begin testing at age 10 yrs or onset of puberty
Test every 3 yrs

A1C test recommended for diagnosis in children and adolescents

At Diagnosis

   • Perform eye exam

   • Measure risk factors

        o Blood pressure

        o Fasting lipids

        o Albumin excretion

After Diagnosis: Similar screening, treatment as for type 1 diabetes for

    • Hypertension

    • Albumin excretion

    • Dyslipidemia

    • Retinopathy

Other issues that may need to be addressed:

polycystic ovarian disease, other pediatric obesity comorbidities§

Children: age ≤18 yrs

*BMI >85th percentile for age and sex, weight for height >85th percentile, or weight >120% ideal for height

†Native American, African American, Latino, Asian American, Pacific Islander

‡Acanthosis nigricans, hypertension, dyslipidemia, PCOS, or small-for-gestational-age birth weight

§Sleep apnea, hepatic steatosis, orthopedic complications, psychosocial concerns