Type 2 Diabetes Mellitus, in Adolescents

Description

Diagnosis

Referral

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ICD-10 Code: E11.9

DESCRIPTION

• The majority of adolescent diabetics are of type 1. However, an increasing number of adolescents are being diagnosed with type 2 diabetes mellitus

Criteria for screening for diabetes in children

• Body mass index >85th percentile for age and sex
• Family history of type 2 diabetes mellitus
• Presence of hyperlipidaemia, hypertension or polycystic ovarian syndrome

AND

• Physical signs of puberty or age >10 years of age

DIAGNOSIS

• Symptoms of diabetes plus a random blood glucose ≥11.1 mmol/L
  • Random is defined as any time of day without regard to time since last meal
  • Classic symptoms of diabetes mellitus include polyphagia, polyuria and polydipsia
• Fasting plasma glucose ≥7.0 mmol/L
  • Fasting is defined as no caloric intake for ≥8 hours

OR

• 2-hour plasma glucose in a 75 g oral glucose tolerance test ≥11.1 mmol/L

It is difficult to distinguish type 2 from type 1 diabetes mellitus, as many type 1 diabetics may be overweight, or have a family history of type 2 diabetes mellitus, given the increasing prevalence of both obesity and type 2 diabetes mellitus. The diagnosis of type 2 diabetes mellitus in adolescents should be made in consultation with a specialist.

REFERRAL

• All patients

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, 2024 Edition