Children and Adolescents with Diabetes: Difference between revisions
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{{CMG}} {{AE}} {{SCh}}; {{MehdiP}}; {{TarekNafee}} | {{CMG}} {{AE}} {{SCh}}; {{MehdiP}}; {{TarekNafee}} | ||
==2016 ADA Standards of Medical Care in Diabetes Guidelines== | ==2016 ADA Standards of Medical Care in Diabetes Guidelines== | ||
===TYPE 1 DIABETES=== | |||
====Diabetes Self-management Education and support==== | |||
{|class="wikitable" | {|class="wikitable" | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Youth with type 1 diabetes and parents/caregivers (for patients aged <18 years) should receive culturally sensitive and developmentally appropriate individualized diabetes self-management education and support according to national standards at diagnosis and routinely thereafter ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
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|} | |||
====Psychosocial Issues==== | |||
{|class="wikitable" | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' At diagnosis and during routine follow-up care, assess psychosocial issues and family stresses that could impact adherence to diabetes management and provide appropriate referrals to trained mental health professionals, preferably experienced in childhood diabetes. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Encourage developmentally appropriate family involvement in diabetes management tasks for children and adolescents, recognizing that premature transfer of diabetes care to the child can result in nonadherence and deterioration in glycemic control ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' Consider mental health professionals as integral members of the pediatric diabetes multidisciplinary team ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |||
|} | |||
====Glycemic Control==== | |||
{|class="wikitable" | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' An A1C goal of <7.5% (58 mmol/mol) is recommended across all pediatric age-groups ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |||
|} | |||
====Autoimmune Conditions==== | |||
{|class="wikitable" | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Assess for the presence of additional autoimmune conditions soon after the diagnosis and if symptoms develop. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |||
|} | |||
====Thyroid Disease==== | |||
{|class="wikitable" | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Consider testing children with type 1 diabetes for antithyroid peroxidase and antithyroglobulin antibodies soon after the diagnosis ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''2.'''Measure thyroid-stimulating hormone concentrations soon after the diagnosis of type 1 diabetes and after glucose control has been established. If normal, consider rechecking every 1–2 years or sooner if the patient develops symptoms suggestive of thyroid dysfunction, thyromegaly, an abnormal growth rate, or an unexplained glycemic variation. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>''' | |} | ||
====Celiac Disease==== | |||
{|class="wikitable" | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Consider screening children with type 1 diabetes for celiac disease by measuring either tissue transglutaminase or deamidated gliadin antibodies, with documentation of normal total serum IgA levels, soon after the diagnosis of diabetes ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Consider screening in children who have a first-degree relative with celiac disease, growth failure, weight loss, failure to gain weight, diarrhea, flatu- lence, abdominal pain, or signs of malabsorption or in children with frequent unexplained hypoglycemia or deterioration in glycemic control. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''3.'''Children with biopsy-confirmed celiac disease should be placed on a gluten- free diet and have a consultation with a dietitian experienced in managing both diabetes and celiac disease. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|} | |} | ||
== | |||
==References== | |||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}}{{WS}} | {{WH}}{{WS}} | ||
Revision as of 19:10, 7 December 2016
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2016 ADA Guideline Recommendations |
|
Types of Diabetes Mellitus |
|---|
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2016 ADA Standard of Medical Care Guideline Recommendations |
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Cardiovascular Disease and Risk Management |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]; Seyedmahdi Pahlavani, M.D. [3]; Tarek Nafee, M.D. [4]
2016 ADA Standards of Medical Care in Diabetes Guidelines
TYPE 1 DIABETES
Diabetes Self-management Education and support
| "1. Youth with type 1 diabetes and parents/caregivers (for patients aged <18 years) should receive culturally sensitive and developmentally appropriate individualized diabetes self-management education and support according to national standards at diagnosis and routinely thereafter (Level of Evidence: B)" |
Psychosocial Issues
| "1. At diagnosis and during routine follow-up care, assess psychosocial issues and family stresses that could impact adherence to diabetes management and provide appropriate referrals to trained mental health professionals, preferably experienced in childhood diabetes. (Level of Evidence: E)" |
| "2. Encourage developmentally appropriate family involvement in diabetes management tasks for children and adolescents, recognizing that premature transfer of diabetes care to the child can result in nonadherence and deterioration in glycemic control (Level of Evidence: B)" |
| "3. Consider mental health professionals as integral members of the pediatric diabetes multidisciplinary team (Level of Evidence: E)" |
Glycemic Control
| "1. An A1C goal of <7.5% (58 mmol/mol) is recommended across all pediatric age-groups (Level of Evidence: E)" |
Autoimmune Conditions
| "1. Assess for the presence of additional autoimmune conditions soon after the diagnosis and if symptoms develop. (Level of Evidence: E)" |
Thyroid Disease
| "1. Consider testing children with type 1 diabetes for antithyroid peroxidase and antithyroglobulin antibodies soon after the diagnosis (Level of Evidence: E)" |
| "2.Measure thyroid-stimulating hormone concentrations soon after the diagnosis of type 1 diabetes and after glucose control has been established. If normal, consider rechecking every 1–2 years or sooner if the patient develops symptoms suggestive of thyroid dysfunction, thyromegaly, an abnormal growth rate, or an unexplained glycemic variation. (Level of Evidence: E)" |
Celiac Disease
| "1. Consider screening children with type 1 diabetes for celiac disease by measuring either tissue transglutaminase or deamidated gliadin antibodies, with documentation of normal total serum IgA levels, soon after the diagnosis of diabetes (Level of Evidence: E)" |
| "2. Consider screening in children who have a first-degree relative with celiac disease, growth failure, weight loss, failure to gain weight, diarrhea, flatu- lence, abdominal pain, or signs of malabsorption or in children with frequent unexplained hypoglycemia or deterioration in glycemic control. (Level of Evidence: E)" |
| "3.Children with biopsy-confirmed celiac disease should be placed on a gluten- free diet and have a consultation with a dietitian experienced in managing both diabetes and celiac disease. (Level of Evidence: B)" |