Type 2 Diabetes mellitus, in adolescents

E11.9

DESCRIPTION

The majority of adolescent diabetics are of type 1. However, an increasing number of adolescents are being diagnosed with type 2 diabetes mellitus.

Criteria for screening for diabetes in children

  • Body mass index > 85th percentile for age and sex.
  • Family history of type 2 diabetesmellitus.
  • Presence of hyperlipidaemia, hypertension or polycystic ovarian syndrome.

AND

  • Physical signs of puberty or age > 10 years of age.

DIAGNOSIS

  • Symptoms of diabetes plus a random blood glucose ≥ 11.1 mmol/L.
    • Random is defined as any time of day without regard to time since last meal.
    • Classic symptoms of diabetes mellitus include polyphagia, polyuria, polydipsia.

OR

  • Fasting blood glucose ≥ 7.0 mmol/L.
    • Fasting is defined as no caloric intake for ≥ 8 hours.

OR

  • 2-hour plasma glucose in a 75 g oral glucose tolerance test ≥ 11.1 mmol/l.

LoE:III[2]

It is difficult to distinguish type 2 from type 1 diabetes mellitus, as many type 1 diabetics may be overweight, or have a family history of type 2 diabetes mellitus, given the increasing prevalence of both obesity and type 2diabetes mellitus. The diagnosis of type 2 diabetes mellitus in adolescents should be made in consultation with a specialist.

REFERRAL

All patients.