Type 2 Diabetes in Children and Adolescents. Arlan L. Rosenbloom

      

      Type 2

      Diabetes

      in

      Children &

      ADOLESCENTS

       Arlan L. Rosenbloom, MD, and Janet H. Silverstein, MD

      Director, Book Publishing, John Fedor; Associate Director, Professional Books, Christine B. Welch; Editor, Joyce Raynor; Production Manager, Peggy M. Rote; Composition, Circle Graphics, Inc.; Cover Design, SueEllen Lawton; Printer, XXXXXXXXXXXX

      © 2003 by the American Diabetes Association, Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.

      Printed in the United States of America

      1 3 5 7 9 10 8 6 4 2

      The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Association—its officers, directors, employees, volunteers, and members—assumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.

      

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      American Diabetes Association

      1701 North Beauregard Street

      Alexandria, Virginia 22311

       Library of Congress Cataloging-in-Publication Data

      Rosenbloom, Arlan L.

      Type 2 diabetes in children and adolescents : a clinician’s guide to diagnosis, epidemiology, pathogenesis, prevention, and treatment / Arlan L. Rosenbloom, Janet H. Silverstein.

       p.; cm.

       Includes bibliographical references.

       ISBN 1-58040-155-4 (pbk. : alk. paper)

       1. Diabetes in children. 2. Diabetes in adolescence. 3. Non-insulin-dependent diabetes. I. Title: Type II diabetes in children and adolescents. II. Title: Type two diabetes in children and adolescents. III. Silverstein, Janet H., 1944- IV. American Diabetes Association. V. Title.

       [DNLM: 1. Diabetes Mellitus, Non-Insulin-Dependent—Child. 2. Adolescent.

      WK 810 R8128t 2003]

      RJ420.D5R57 2003

      618.92’462—dc21

      2002033007

      eISBN: 978-1-58040-365-8

      Contents

       Acknowledgments

       1 Introduction

       2 Diagnosis and Classification of Diabetes in Children

       Definition

       Classification

       Diagnostic Strategy

       3 Epidemiology of Type 2 Diabetes and Obesity in Children

       Evidence for an Epidemic of Type 2 Diabetes in Children

       The Epidemic of Obesity

       4 Causes of the Insulin Resistance Syndrome and Type 2 Diabetes

       Metabolic Pathology

       Genetic Basis for Insulin Resistance and Type 2 Diabetes

       Role of Fetal and Childhood Nutrition

       Role of Maternal Diabetes

       Polycystic Ovarian Syndrome and Premature Adrenarche

       Racial and Familial Influences

       Puberty and Insulin Resistance

       Obesity and Insulin Resistance: The Essential Problem

       The Insulin Resistance Syndrome

       5 Case Finding: Who Should Be Tested?

       Epidemiologic Criteria for Case Finding

       Testing Recommendations

       6 Is Type 2 Diabetes in Children Preventable? The Individual and Community Challenge

       Definitions

       Primary Prevention/Intervention

       Secondary Prevention/Intervention

       7 Treatment

       Introduction

       Treatment Goals

       Treatment Principles

       Behavioral