Diabetes Type 2 In Children, Clinical Presentation, Diagnosis, Screening, And Management Discussion Response
Diabetes Type 2 In Children, Clinical Presentation, Diagnosis, Screening, And Management Discussion Response
Discussion Response: Type 2 Diabetes
I concur that Type 2 diabetes is the most common type of diabetes that is characterized by insulin resistance, hyperglycemia, and impairment that exists in the secretion of insulin. Your discussion of diabetes type 2 in children is elaborative as it touches on the clinical presentation, how the disease is diagnosed, the screening process, and management. (Artasensi et al., 2020) indicate that Type 2 diabetes in both adolescents and children has grown to become an emerging pandemic in the last 20 years. Following the symptoms you have presented in your discussion, patients having type 2 diabetes mellitus can use medications to increase their bodies’ receptivity to insulin or lessen the amount of glucose their livers manufacture. Such kind of diabetes mellitus is typically linked to lifestyle choices including obesity, a lack of exercise, an unbalanced diet, an excessive intake of sweets and other sugary beverages, etc. Your discussion is in line with the findings of Oguntibeju (2019) which suggest that children aged 10-years-old and obese, should undergo screening for type 2 diabetes Diabetes Type 2 In Children, Clinical Presentation, Diagnosis, Screening, And Management Discussion Response.
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Screening of type 2 diabetes is recommended to begin at age 10 according to the American Diabetes Association (ADA). For those with a BMI above 85%, I would recommend the onset of puberty as the best time for screening. The clinician should have a high index of suspicion to note issues such as family history, signs of insulin resistance, high-risk race, and gestational diabetes, which are indicators at screening should be done. Symptomatic patients are evaluated for the random plasma glucose, A1C, and urinalysis to evaluate for glycosuria and ketonuria. The diagnostic criteria include A1C greater than 6.5%, fasting glucose greater than 126 mg/dl, random plasma glucose greater than 200mg/dl, and two-hour plasma glucose greater than 200mg/dl (Goyal et al., 2020).
It is true to say that lifestyle interventions for patients living with type2 diabetes is an integral part of management for glycemic control and overall wellbeing. Patients should be counseled on the types of food to consume, routine exercise, and family involvement. All these interventions delay the onset of type 2 diabetes and control prediabetes (Li et al., 2020). Metformin is available in liquid form and is increased gradually to prevent gastrointestinal side effects.
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Type 2 diabetes is characterized by hyperglycemia, insulin resistance, and relative impairment in insulin secretion. The article discusses diabetes type 2 in children, clinical presentation, diagnosis, screening, and management. The presentation of T2DM in children and adolescents includes symptoms of hyperglycemia, diabetic ketoacidosis, or hyperosmolar hyperglycemia. Children may present as symptomatic or asymptomatic. Some patients are tested because of risk factors or from glycosuria from urinalysis and may be asymptomatic. Symptomatic symptoms are due to hyperglycemia and commonly include polyuria, polydipsia, and nocturia, like those in patients with type 1 diabetes mellitus. Symptomatic patients also may have experienced weight loss, although this is not a common presenting complaint. Initial presentation may include diabetic ketoacidosis. 32% of adolescents have hypertension at the time of diagnosis (Hanna & Michael, 2018).
According to The American Diabetes Association, screening should begin at age 10 or the onset of puberty if BMI is greater than the 85th percentile. Other indications to screen include two of the following risk factors: family history, gestational diabetes, high-risk race, and signs of insulin resistance. If results are negative, screening should be repeated every three years. The first steps for symptomatic patients are to measure random plasma glucose, A1c, and urinalysis to evaluate for glucosuria and ketonuria. Diagnostic criteria include A1C greater than 6.5%, fasting glucose greater than 126 mg/dl, random plasma glucose greater than 200mg/dl, and two-hour plasma glucose greater than 200mg/dl (Hanna & Michael, 2018)Diabetes Type 2 In Children, Clinical Presentation, Diagnosis, Screening, And Management Discussion Response.
Lifestyle interventions such as nutritional counseling, exercise counseling, and family involvement are recommended for patients with type 2 diabetes. Studies suggest that lifestyle interventions can prevent prediabetes and can prevent or delay the onset of type 2 diabetes. Metformin with diet and exercise is the first-line treatment in children 10 years and older. Metformin and insulin are the only medications approved for type 2 diabetes in children. Prompt diagnosis and appropriate therapy are important because the risk of related complications is related to the duration of the disease (Hanna & Michael, 2018).
References
Artasensi, A., Pedretti, A., Vistoli, G., & Fumagalli, L. (2020). Type 2 diabetes mellitus: a review of multi-target drugs. Molecules, 25(8), 1987.
Goyal, A., Gupta, Y., Singla, R., Kalra, S., & Tandon, N. (2020). American Diabetes Association “Standards of Medical Care—2020 for Gestational Diabetes Mellitus”: A Critical Appraisal. Diabetes Therapy, 11(8), 1639-1644.
Li, Y., Teng, D. I., Shi, X., Qin, G., Qin, Y., Quan, H., & Shan, Z. (2020). Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. bmj, 369.
Oguntibeju, O. O. (2019). Type 2 diabetes mellitus, oxidative stress and inflammation: examining the links. International journal of physiology, pathophysiology and pharmacology, 11(3), 45Diabetes Type 2 In Children, Clinical Presentation, Diagnosis, Screening, And Management Discussion Response.