Skip to Main Content

++

Until the 1970s, the care of childhood diabetes was pursued by internists, pediatricians, nephrologists, and general physicians. In 1971 it was estimated that visits for diabetes by those 0 to 15 years of age were equally divided among internists, general physicians, and general pediatricians.1 At that time there were few pediatric endocrinologists, and most of them did not consider diabetes to be an endocrine disorder. By 1993, pediatricians accounted for two thirds of all visits of 0- to 21-year-old diabetes patients, and over half of these were to pediatric endocrinologists; the remainder were to internists (most likely the older adolescents and young adults).2 The contemporary epidemic of obesity-related type 2 diabetes (T2D) in youth has confronted pediatricians and pediatric diabetes specialists with responsibility for a condition that was previously rare in the pediatric age group. This obesity/T2D epidemic has had pediatricians dealing with various comorbidities of insulin resistance that were formerly the exclusive domain of physicians treating adults.3

++

The diagnosis of diabetes includes a wide variety of diseases characterized by hyperglycemia. Because insulin is the only physiologically important hypoglycemic hormone, hyperglycemia is the result of either impaired secretion of insulin from the beta cells of the pancreas (type 1 diabetes) or resistance to the effect of insulin in the liver, muscle, and fat cells exceeding a limited capacity of the pancreas to compensate (type 2 diabetes). Criteria for the diagnosis of diabetes were revised in 2005 and prediabetes categories of impaired glucose tolerance and impaired fasting glucose added; this change reflected the recognition that these preclinical glucose intolerance states are associated with increased cardiovascular morbidity.4 The information in Table 544-1 is based on the current recommendations of the American Diabetes Association.4

++
Table Graphic Jump Location
Table 544-1. Criteria for the Diagnosis of Diabetes

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.