Increasing Incidence of Type 2 Diabetes in the Pediatric Population在儿科人群2型糖尿病的发病率增加.pptVIP

Annual Screening TIDM Family history of hypercholesterolemia * If LDL 100 screen every 5 years. Annual microalbumin/creatinine ratio: age 10 and TIDM for 5 years, Annual ophthalmologic exam: age 10 and 3-5 years of TIDM Screen for Thyroid Peroxidase and Thyroglobulin, Transglutaminase or Endomysial Abs at diagnosis TSH q 1-2 yrs * TC 240 and/or Cardiac Event 55 Screen age 2 otherwise begin screen at 12. T2DM Lipid Panel yearly Microalbumin/creatinine ratio at diagnosis and yearly Dilated eye exam at diagnosis and yearly Liver function every 6 months if on metformin IDENTIFYING CHILDREN AT RISK for TYPE 2 DIABETES Obesity- BMI 85% for age weight 120% for height Family history in 1st or 2o relative Race/ethnicity (American Indian, African American, Hispanic, Asian/Pacific Islander) Condition associated with insulin resistance Acanthosis Nigricans Hypertension Dyslipidemia Polycystic Ovary Syndrome TESTING at RISK CHILDREN How- Fasting Blood Sugar Who- 8 years old or pubertal child When- every 2 years Type 1 DM TrialNet – natural history study for 1st degree relatives of people with type 1 diabetes PREVENTION of TYPE 2 DIABETES in CHILDREN Anticipatory Guidance - Breast feeding, Nutrition Healthcare Maintenance Community Involvement - Nutrition and Exercise in Schools * 11 * 3 * This is a 24 hour representation of the insulin profile for someone who does not have diabetes. The pancreas releases insulin for each meal, but there is always a constant background or basal amount present that has nothing to do with food. * This shows the basal/bolus regimen with the background or basal insulin as the thick black line at the bottom. Meal or bolus doses are delivered in varying amounts and times according to meals. * Campers on this injection regimen would be getting shots at breakfast and supper. The breakfast shot combines a short-acting insulin shown as the dotted line which covers just that meal. The intermediate-