Dewan Presentation 2007

Dewan Presentation 2007 - DIAGNOSIS AND DIAGNOSIS AND...

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Unformatted text preview: DIAGNOSIS AND DIAGNOSIS AND TREATMENT OF TYPE 2 TREATMENT OF TYPE 2 DIABETES IN CHILDREN DIABETES IN CHILDREN Asheesh Dewan, M.D. Outline of Discussion Outline of Discussion The importance of the problem Diagnosis of type 2 diabetes in children Special problems in children with T2DM Management based on presentation The metformin trial Comorbid conditions ELEVATED GLUCOSE PANCREAS 1. Increased Hepatic Glucose Production Pathogenesis of Type 2 Pathogenesis of Type 2 Diabetes Diabetes 2. Impaired Pancreatic Insulin Secretion 3. Peripheral Insulin Resistance MUSCLE LIVER Outline of Discussion Outline of Discussion The importance of the problem Diagnosis of type 2 diabetes in children Special problems in children with T2DM Management based on presentation The metformin trial Comorbid conditions okdad et al. Diabetes Care . 2000;23:1278. Diabetes Trends in the United Diabetes Trends in the United States States Prevalence of diagnosed diabetes increased by 33% from 1990 to 1998 Age (y) % Increase 30–39 70 40–49 40 50–59 31 Highly correlated with prevalence of obesity (r = 0.64, P < 0.001) Diabetes Trend with Obesity Diabetes Trend with Obesity World wide trend of Type 2 Diabetes from 2000 to 2010 World wide trend of Type 2 Diabetes from 2000 to 2010 Numbers of people with diabetes (in millions) for 2000 and 2010 (top and middle values, respectively), and the percentage increase. Source : Nature 414 , 782 - 787 (2001) Projected Obesity prevalence from 1960 to 2025 Projected Obesity prevalence from 1960 to 2025 Source: Nature 404, 2000 J Pediatr . May 2000. Type 2 Diabetes in Children Type 2 Diabetes in Children Epidemiology: Population-Based Epidemiology: Population-Based Population Age (y) Sample Size Prevalence per 1000 Navajo Indians 12–19 142 14.1 10–14 672 22.3 Pima Indians 15–19 530 50.9 4–19 717 11.1 Cree and Ojibway 10–19 – 0 for males 36 for females US Caucasians, African Americans (AA), and Mexican Americans (MA) 12–19 2867 4.1 Type 2 Diabetes in Children Type 2 Diabetes in Children Epidemiology: Case Studies Epidemiology: Case Studies Location Population New Diabetes Cases (%) Cincinnati, OH Caucasians and AA 33 Charleston, SC AA 46 Little Rock, AR Caucasians, AA, and Latinos – San Diego, CA MA 18 San Antonio, TX MA 18 Ventura, CA MA 45 Fagot-Campana et al. J Pediatr. 2 4 6 8 10 12 14 16 1990 1991 1992 1993 1994 1995 1996 1997 1998 P a t i e n t s Type 2 Diabetes in Children: Type 2 Diabetes in Children: Diagnosis by Year Diagnosis by Year Prevalence of IFG in Nondiabetic US Adolescents Prevalence of IFG in Nondiabetic US Adolescents (Aged 12–19 Yrs) (Aged 12–19 Yrs) ADA Guidelines for Screening, ADA Guidelines for Screening, Treatment of Children, Adolescents Treatment of Children, Adolescents ADA Guidelines for Screening, ADA Guidelines for Screening, Treatment of Children, Adolescents (cont.) Treatment of Children, Adolescents (cont.) Outline of Discussion...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Dewan Presentation 2007 - DIAGNOSIS AND DIAGNOSIS AND...

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