Peterson Kevin, Silverstein Janet, Kaufman Francine, Warren-Boulton Elizabeth
Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA.
Am Fam Physician. 2007 Sep 1;76(5):658-64.
Although type 1 diabetes historically has been more common in patients eight to 19 years of age, type 2 diabetes is emerging as an important disease in this group. Type 2 diabetes accounts for 8 to 45 percent of new childhood diabetes. This article is an update from the National Diabetes Education Program on the management of type 2 diabetes in youth. High-risk youths older than 10 years have a body mass index greater than the 85th percentile for age and sex plus two additional risk factors (i.e., family history, high-risk ethnicity, acanthosis nigricans, polycystic ovary syndrome, hypertension, or dyslipidemia). Reducing overweight and impaired glucose tolerance with increased physical activity and healthier eating habits may help prevent or delay the development of type 2 diabetes in high-risk youths. The American Academy of Pediatrics does not recommend population-based screening of high-risk youths; however, physicians should closely monitor these patients because early diagnosis may be beneficial. The American Diabetes Association recommends screening high-risk youths every two years with a fasting plasma glucose test. Patients diagnosed with diabetes should receive self-management education, behavior interventions to promote healthy eating and physical activity, appropriate therapy for hyperglycemia (usually metformin and insulin), and treatment of comorbidities.
虽然1型糖尿病在历史上在8至19岁的患者中更为常见，但2型糖尿病正在成为该群体中的一种重要疾病。2型糖尿病占新诊断儿童糖尿病的8%至45%。本文是美国国家糖尿病教育计划关于青少年2型糖尿病管理的最新内容。10岁以上的高危青少年的体重指数高于其年龄和性别的第85百分位数，且伴有另外两个风险因素（即家族史、高危种族、黑棘皮病、多囊卵巢综合征、高血压或血脂异常）。通过增加体育活动和养成更健康的饮食习惯来减轻超重和改善糖耐量受损，可能有助于预防或延缓高危青少年2型糖尿病的发生。美国儿科学会不建议对高危青少年进行基于人群的筛查；然而，医生应密切监测这些患者，因为早期诊断可能有益。美国糖尿病协会建议每两年用空腹血糖检测对高危青少年进行筛查。被诊断为糖尿病的患者应接受自我管理教育、促进健康饮食和体育活动的行为干预、针对高血糖的适当治疗（通常是二甲双胍和胰岛素）以及合并症的治疗。
