| Treatment of type 2 diabetes mellitus in children and adolescents. | |
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MedLine Citation:
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PMID: 11202216 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The treatment of type 2 diabetes mellitus (DM) is directed at decreasing insulin resistance and increasing insulin secretion. alpha-Glucosidase inhibitors slow carbohydrate absorption, resulting in reduced postprandial hyperglycemia; thiazolidinediones increase insulin sensitivity, especially in muscle and adipocytes; metformin decreases hepatic gluconeogenesis; sulfonylureas result in prolonged increases in insulin secretion; and meglitinide causes rapid, short-lived increases in insulin secretion. A survey of 130 pediatric endocrinology practices in the USA and Canada indicated that 48% of children with type 2 DM were treated with insulin and 44% with one or more oral hypoglycemic agents (OHA). Of those treated with OHA, 71% received metformin, 46% sulfonylureas, 9% thiazolidinediones and 4% meglitinide. Similarly, in the three university-based diabetes centers in Florida, 50% of the children with type 2 DM were treated with OHA. Treatment is based on symptoms at presentation. Patients identified on routine testing are often treated with exercise and diet alone. Those who are mildly symptomatic at onset are often started on OHA. Patients with substantial ketosis, ketoacidosis or markedly elevated blood glucose levels are initially treated with insulin, followed by a tapering of the dose and the addition of an OHA after blood glucose control is established and symptoms subside. There are no studies of the efficacy or compliance with treatment for type 2 DM in adolescents. Treatment is currently based on the clinical experience with adults. Controlled clinical trials in children are essential. |
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Authors:
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J H Silverstein; A L Rosenbloom |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Journal of pediatric endocrinology & metabolism : JPEM Volume: 13 Suppl 6 ISSN: 0334-018X ISO Abbreviation: J. Pediatr. Endocrinol. Metab. Publication Date: 2000 |
Date Detail:
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Created Date: 2001-01-30 Completed Date: 2001-03-29 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 9508900 Medline TA: J Pediatr Endocrinol Metab Country: England |
Other Details:
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Languages: eng Pagination: 1403-9 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, University of Florida College of Medicine, Children's Medical Services Center, Gainesville 32608-1153, USA. silvejh@peds.ufl.ed |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Blood Glucose / analysis Child Diabetes Mellitus, Type 2 / complications, epidemiology, physiopathology, therapy* Diet Exercise Humans Hypoglycemic Agents / therapeutic use Insulin / secretion Insulin Resistance |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Hypoglycemic Agents; 11061-68-0/Insulin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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