TY - CHAP M1 - Book, Section TI - Preface A1 - Kappy, Michael S. A1 - Allen, David B. A1 - Geffner, Mitchell E. PY - 2013 T2 - Pediatric Practice: Endocrinology, 2e AB - Of the many attractive qualities of pediatric endocrinology, two in particular—its diversity of disorders and its intrinsically pediatric focus on growth and physical development—amplify the importance of practical knowledge of this specialty for the primary care provider. In the past, apart from type 1 diabetes, endocrine problems in clinical practice were relatively rare; they required a pediatric health care expert to differentiate their distinguishing features from the breadth of normal variations in ruling such disorders out much more often than in. During the past 20 years, however, as the incidence of type 1 diabetes mellitus has increased, other diseases that were infrequently seen in children— obesity-associated insulin resistance, metabolic syndrome, type 2 diabetes mellitus, and polycystic ovarian syndrome—have emerged as common occurrences in pediatric primary care. Ethnic demographic changes, growth and puberty acceleration due to excess nutrition, and possibly other factors have reduced the mean age of appearance of first puberty signs so that normal variations must now be distinguished more frequently from pathological causes of precocious puberty. The expanded availability and variety of (often controversial) growthpromoting and puberty-altering treatments have created therapeutic options for a broadening spectrum of children, for whom critical evaluation of benefit, cost, and risk is required. Further, in the United States, every new baby is now screened for congenital adrenal hyperplasia as well as congenital hypothyroidism. Because of these changes among others, the primary child health care provider ponders possible endocrine diagnoses and/or therapeutics virtually every day. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1102499373 ER -