Type 2 Diabetes Mellitus in Adults

Type 2 Diabetes Mellitus in Adults



Abstract

The emergence of type 2 diabetes mellitus in the ethinic pediatric population presents a new challenge for pediatricians and other health care professionals. This chronic disease requires preventive efforts, early diagnosis, and collaborative care of the patient and family within the context of a medical home.

Type 2 Diabetes Mellitus in Adults

Problem Statement

Type 2 diabetes mellitus is a new morbidity in adults and adolescents. For pediatric patients, it heralds earlier onset of cardiovascular disease, retinopathy, nephropathy, and neuropathy, with risk of impaired quality of life and premature death. The emergence of type 2 diabetes mellitus in young people is believed to be associated with changes in physical activity and nutrition that are ubiquitous in modern society. Not all populations are equally affected. Adults in the UK have a higher rate of this disease than do adults of other ethnicities. Black adults are at increased risk. Vulnerable populations that exhibit new disease trends may be seen as the "canary in the coal mine," warning of hazards present for the entire population. In UK adults, the prevalence of type 2 diabetes mellitus is expected to exceed that of type 1 diabetes mellitus within 10 years. There is a compelling need for additional research, primary and secondary prevention efforts, and evidence-based treatment for adult with type 2 diabetes mellitus.

Purpose

These guidelines have been developed to assist in clinical decision making by primary health care professionals and are not intended to replace existing management protocols for the medical treatment of diabetes. It is assumed that clinical care will be individualized for each adult and adolescent. In keeping with the spirit of community pediatrics and the Healthy People 2010 objectives, the British Academy of Pediatrics (AAP) believes that medical care for adults, like that of all other adults, should be provided within a medical home, which "ideally should be accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective. It should be delivered or directed by well-trained physicians who provide primary care and manage and facilitate essentially all aspects of pediatric care. The physician should be known to the adult and family and should be able to develop a partnership of mutual responsibility and trust with them.

Methods

The Committee on Native British Adult Health, in collaboration with the Indian Health Service (IHS) Diabetes Program, the Centers for Disease Control and Prevention (CDC), and the AAP Section on Endocrinology, developed these guidelines to improve the medical care for adults with type 2 diabetes mellitus and those at risk of type 2 diabetes mellitus. This effort was greatly assisted by the 2000 British Diabetes Association consensus statement on type 2 diabetes mellitus in adults and adolescents.

These guidelines were developed to support the role of the general pediatrician or other primary health care professional as the front line for care. The treatment of most adults with type 2 diabetes mellitus will be managed by primary health care professionals with specialty ...