Diabetes Mellitus in Children and Adolescents (Major Problems in Clinical Pediatrics)

CONTENTS......Page 2 FORTHCOMING ISSUES......Page 7 Diabetes Mellitus in Children......Page 8 The Classification of Diabetes Mellitus: A Conceptual Framework......Page 10 Physiology......Page 12 Biochemical and molecular aspects of insulin secretion......Page 15 Euglycemic hyperinsulinemic clamp......Page 18 Homeostatic model assessment......Page 20 The interaction of insulin resistance and beta-cell function......Page 21 Mitochondrial diabetes......Page 22 Metabolic syndrome......Page 23 Type 2 diabetes mellitus......Page 24 Summary......Page 25 References......Page 26 Epidemiology: incidence and prevalence......Page 30 Economics of health care......Page 31 Natural history of prediabetes......Page 32 Genetics......Page 33 Autoimmunity and autoantibodies......Page 35 Environment......Page 37 Presentations: classic, silent, and diabetic ketoacidosis......Page 40 Management in new-onset diabetes......Page 42 Ongoing diabetes management......Page 43 Subcutaneous insulin regimens: neutral protamine Hagedorn and rapid acting analogs......Page 44 Potential adjuncts to insulin therapy......Page 45 Medical nutritional therapy......Page 46 Hypoglycemia......Page 47 School issues......Page 48 Complications......Page 49 Future......Page 50 References......Page 52 Type 2 Diabetes Mellitus in Youth: The Complete Picture to Date......Page 56 Epidemiology......Page 57 Insulin resistance and insulin secretion in type 2 diabetes mellitus......Page 58 Natural history of youth type 2 diabetes mellitus......Page 62 Environment: behavior and lifestyle translate into a risk for obesity and altered body fat distribution......Page 63 Insulin resistance phenotype......Page 64 Acanthosis nigricans......Page 65 Criteria for the diagnosis of diabetes......Page 66 Screening of children and adolescents at risk for type 2 diabetes mellitus......Page 67 Pancreatic autoantibodies in youth type 2 diabetes mellitus......Page 69 Comorbidities and complications of youth type 2 diabetes mellitus......Page 71 Team approach and goals of treatment......Page 72 Insulin......Page 73 Other oral agents......Page 74 Acute complications......Page 75 Dyslipidemia......Page 76 Summary......Page 77 References......Page 78 Pediatric Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State......Page 87 Pathophysiologic abnormalities early in the development of diabetic ketoacidosis......Page 88 Pathophysiologic abnormalities later in the development of diabetic ketoacidosis......Page 89 Clinical manifestations of diabetic ketoacidosis......Page 91 Hyperglycemia......Page 93 Electrolyte abnormalities......Page 94 Other biochemical abnormalities......Page 95 Insulin and dextrose......Page 96 Electrolytes......Page 97 Bicarbonate......Page 99 Complications......Page 100 Differential diagnosis......Page 103 Hyperglycemic hyperosmolar state without ketosis......Page 104 Summary......Page 105 References......Page 106 Maturity-onset diabetes of the young......Page 112 Physiology of the beta-cell and the role of maturity-onset diabetes of the young genes......Page 113 Treatment......Page 115 Transient neonatal diabetes......Page 116 Permanent neonatal diabetes......Page 117 Wolfram syndrome......Page 118 Mitochondrial diabetes......Page 119 Cystic fibrosis-related diabetes......Page 120 Insulin receptor defects......Page 121 Congenital lipoatrophic diabetes......Page 122 References......Page 123 Insulin Analogues in Children and Teens with Type 1 Diabetes: Advantages and Caveats......Page 126 Development of insulin formulations......Page 127 Rapid-acting analogues: meal-related (bolus) insulin......Page 128 Basal insulins: (very) long-acting insulin analogues......Page 132 Safety of insulin analogues......Page 134 Insulin aspart in adults who have type 1 diabetes......Page 135 Rapid-acting analogues in children and adolescents who have type 1 diabetes......Page 136 Insulin glargine in adults who have type 1 diabetes......Page 138 Very long-acting insulin analogues in children and adolescents who have type 1 diabetes......Page 141 Continuous subcutaneous insulin infusion (pump therapy)......Page 142 Adjunctive therapies......Page 143 References......Page 145 Insulin Pump Treatment of Childhood Type 1 Diabetes......Page 151 Safety and efficacy of continuous subcutaneous insulin infusion in youth: clinical outcome studies......Page 153 Safety and efficacy of continuous subcutaneous insulin infusion in youth: results of randomized clinical trials......Page 156 Subjective and other benefits of continuous subcutaneous insulin infusion......Page 157 Toward a brighter future......Page 158 References......Page 160 Oral Agents in Managing Diabetes Mellitus in Children and Adolescents......Page 163 Type 2 diabetes mellitus......Page 164 Metformin......Page 165 Thiazolidinediones......Page 167 Glitinides......Page 169 Treatment plan for management of type 2 diabetes mellitus......Page 170 Summary......Page 174 References......Page 175 Hypoglycemia: A Complication of Diabetes Therapy in Children......Page 178 Defining hypoglycemia......Page 179 Prevalence of hypoglycemia......Page 180 Glucose counterregulation......Page 181 Glucose transporters......Page 182 Physiologic consequences......Page 183 Symptom detection......Page 185 Acute neurologic sequelae......Page 186 Transient cognitive deterioration......Page 187 Acute electroencephalographic changes......Page 189 Permanent cognitive sequelae of severe or recurrent hypoglycemia......Page 190 Chronic electroencephalographic abnormalities......Page 192 Risk factors for hypoglycemia......Page 193 Intervention strategies......Page 194 Treatment of acute episodes......Page 195 Summary......Page 196 References......Page 197 Pathogenesis......Page 207 The importance of glycemic control......Page 208 Diabetic retinopathy......Page 209 Interventions......Page 212 Diabetic nephropathy......Page 213 Interventions......Page 214 Peripheral neuropathy......Page 215 Interventions......Page 216 Associated autoimmune diseases......Page 217 Discussing complications......Page 218 References......Page 220 Interactions between psychologic adjustment and family management of type 1 diabetes in children and adolescents......Page 226 Family environment and parental involvement......Page 227 Psychologic and behavioral problems......Page 228 Peer relationships......Page 229 School issues......Page 230 Pediatric type 1 diabetes: psychologic interventions......Page 231 Treatment adherence......Page 232 Family communication and problem solving......Page 233 Anxiety and stress management......Page 234 Future research......Page 235 Differences in the psychologic contexts of type 1 versus type 2 diabetes mellitus......Page 236 Risk factors for developing type 2 diabetes mellitus......Page 237 Behavioral intervention and prevention efforts......Page 238 Summary: keys to intervention......Page 240 Prevent adjustment problems and promote family teamwork......Page 241 Refer for appropriate services and encourage engagement......Page 242 Seek continuing education regarding psychologic aspects of diabetes......Page 243 References......Page 244 Islet autoantibodies......Page 250 The role of major histocompatibility complex in type 1 diabetes mellitus prediction studies......Page 254 Proposed guidelines for screening......Page 256 Primary prevention......Page 257 Secondary prevention......Page 259 Parenteral and oral insulin: Diabetes Prevention Trial Type 1......Page 260 Tertiary prevention......Page 262 Anti-CD3 treatment......Page 263 Pancreas and islet transplantation......Page 266 Stem cell therapy, gene therapy, and other therapies......Page 267 References......Page 269