Use Same Diabetes Treatment for Children and Adults

A combination of metformin and lifestyle changes should be used to treat children and teens with type 2 diabetes, much the same way that adults are treated, stated a new guideline from the American Academy of Pediatrics. 

Those children presenting with ketosis or diabetic ketoacidosis, along with those in which distinction between types 1 and 2 diabetes is unclear are the exception, and should begin insulin therapy immediately. 

The guideline also cautioned physicians about the gastrointestinal effects of high-dose metformin, although reassured that such effects often disappear with continued use. 

The ease of use of oral medications over injections also factored in to the decision to recommend metformin over insulin. 

It recommends that any pediatrician not confident in their ability to treat the child, for any of a number of reasons, should refer the child to a subspecialist, with which the primary care physician should develop a “co-management strategy…to ensure that the child continues to receive appropriate care consistent with a medical home model in which the pediatrician partners with parents to ensure that all health needs are met.”

-Michael Potts

References                            

Copeland K, Silverstein J, Moore K, et al.  Management of Newly Diagnosed Type 2 Diabetes Mellitus (T2DM) in Children and Adolescents [published online ahead of print January 28, 2013].  Pediatrics. doi: 10.1542/peds.2012-3494