Management of Diabetes in Pregnancy, Childhood, and Adolescence

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Primary care physicians are likely to become involved with the management of many types of patients who have diabetes, including children and adolescents. Although specialty consultation is necessary for these young patients, the primary care physician often provides a strong cornerstone of therapy revolving around complication surveillance, disease prevention (especially in patients who have gestational diabetes following the completion of their pregnancy), motivation toward making healthy lifestyle choices, and support of the family unit once a new diagnosis of type 1 diabetes mellitus is made. By promoting a healthy lifestyle to high-risk patients, primary care physicians can help delay the onset and reduce the incidence of type 2 diabetes in children and adolescents.

Section snippets

Management of type 1 diabetes during pregnancy

Most women who have diabetes who become pregnant will require the services of a perinatologist, an obstetrician, a registered dietician, a certified diabetes educator, and an endocrinologist who specializes in diabetic pregnancies. Patients who have type 1 diabetes mellitus (T1DM) who become pregnant have a number of perinatal, labor and delivery, and postpartum challenges that can be successfully managed by the specialty team.

Insulin requirements change throughout pregnancy. During the first

Type 2 diabetes

No longer considered to be a condition of primarily adult onset, T2DM has become increasingly common among children aged 6 to 11 years and adolescents aged 12 to 19 years. Although there has been no definitive large-scale reporting of incidence within these age groups, a recent epidemiological review has led to the suggestion that as many as 8% to 45% of new-onset pediatric diabetes cases in the United States may be type 2 [48]. The Centers for Disease Control and Prevention reported 206,000

Summary

Primary care physicians are likely to become involved with the management of many types of patients who have diabetes, including children and adolescents. Although specialty consultation is necessary for these young patients, the primary care physician often provides a strong cornerstone of therapy, revolving around complication surveillance, disease prevention (especially in patients who have GDM following the completion of their pregnancy), motivation toward making healthy lifestyle choices,

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