At least the American Academy ofPediatrics (AAP) has issued a set of guidelines to provideevidence-based recommendations on managing type 2 diabetes inchildren ages 10 to 18. The American Diabetes Association still doesnot know how to deal with children and adolescents unless they havetype 1 diabetes. Type 2 does not seem to be on their list ofobjectives.
The guidelines are in a PDF file andcan be downloaded and opened by Adobe Reader. Then they can be savedto another file. I think what Dr Bill Quick says is worth quoting. “Awarning to those of you who might be interested in reading theguidelines: they are very lengthy and very wordy. So don’t expectto be able to hand a copy to your physician and have the doc scan itand comment upon it while you wait… But if your medical team seeskids with diabetes, and isn’t aware of these guidelines, it wouldbe worthwhile to let them know these guidelines exist.”
The files - “Guidelines full text”and “Technical report full text” for downloading can be foundhere at the end of this Medscape article. I have to be fair and listthe other medical organizations that assisted the AAP in developingthe guidelines. They were developed with support from the AmericanDiabetes Association, the Pediatric Endocrine Society, the AmericanAcademy of Family Physicians, and the Academy of Nutrition andDietetics (formerly the American Dietetic Association).
Coauthor Janet Silverstein, MD,professor of pediatrics at the University of Florida and chief ofendocrinology at Shands Hospital, Gainesville, FL has made somestatements to Medscape that are important to be considered. “Firstis a recommendation for insulin treatment in all patients who presentwith ketosis or extremely high blood sugar, in whom it may not beclear initially whether they have type 2 or type 1 diabetes. This isimportant because overweight or obese children are frequentlymisdiagnosed as having type 2 when in fact they are positive forantibodies associated with type 1.”
Her next statement is more important. “Once type 2 diabetes is confirmed,lifestyle modification along with metformin as first-line therapy isrecommended. Metformin and insulin are the only 2 glucose-loweringmedications currently approved in youth less than 18 years, butothers are being studied.” I would urge everyone toread the Medscape article and consider downloading at least theGuidelines.
Hiç yorum yok:
Yorum Gönder