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
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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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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
2 Diagnosis and Classification of Diabetes in Children
Definition
3 Epidemiology of Type 2 Diabetes and Obesity in Children
Evidence for an Epidemic of Type 2 Diabetes in Children
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
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
6 Is Type 2 Diabetes in Children Preventable? The Individual and Community Challenge
Definitions
Primary Prevention/Intervention
Secondary Prevention/Intervention
Introduction