Journal Article

ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents

Craig, Maria E., Kahkoska, Anna R., Dabelea, Dana, Aschner, Pablo, Mayer‐Davis, Elizabeth J., Gong, Chun X., Jefferies, Craig, Balde, Naby

2018

Overview

The possibility of other types of diabetes should be considered in the child who has negative diabetes-associated autoantibodies and (B): an autosomal dominant family history of diabetes (maturity-onset diabetes of the young [MODY]) age less than 12 months and especially in first 6 months of life (NDM [neonatal diabetes mellitus]) mild-fasting hyperglycemia (5.5-8.5 mmol [100-150 mg/dL]), especially if young, non-obese, and asymptomatic a prolonged honeymoon period over 1 year or an unusually low requirement for insulin of ≤0.5 U/kg/day after 1 year of diabetes associated conditions such as deafness, optic atrophy, or syndromic features (mitochondrial disease) a history of exposure to drugs known to be toxic to β-cells or cause insulin resistance (eg, immunosuppressive drugs such as tacrolimus or cyclosporin; gluocorticoids or some antidepressants). While type 1 diabetes remains the most common form of diabetes in young people in many populations, especially those of European background, type 2 diabetes has become an increasingly important public health concern globally among children in high risk ethnic populations as well as in those with severe obesity, see ISPAD guideline on type 2 diabetes . Diabetes in young people usually presents with characteristic symptoms such as polyuria, polydipsia, nocturia, enuresis, weight loss—which may be accompanied by polyphagia, behavioral disturbance including reduced school performance, and blurred vision. Glycated hemoglobin (HbA1c) can be used as a diagnostic test for diabetes providing that stringent quality assurance tests are in place and assays are standardized to criteria aligned to the international reference values, and there are no conditions present which preclude its accurate measurement. [...]the validity of HbA1c as a measure of average glucose is complicated in the context of hemoglobinopathies, certain forms of anemia, or any other condition that affects normal red blood cell turnover.

• Publisher: John Wiley & Sons A/S,John Wiley & Sons, Inc
• Subject: Adolescent / Adolescents / Child / Children / Consensus / Diabetes / Diabetes mellitus / Diabetes Mellitus, Type 1 - classification / Diabetes Mellitus, Type 1 - diagnosis / Diabetes Mellitus, Type 1 - epidemiology / Diabetes Mellitus, Type 2 - classification / Diabetes Mellitus, Type 2 - diagnosis / Diabetes Mellitus, Type 2 - epidemiology / Diagnosis, Differential / Diagnostic Techniques, Endocrine - standards / Diagnostic Techniques, Endocrine - trends / Endocrinology - methods / Endocrinology - organization & administration / Endocrinology - standards / Humans / International Cooperation / Pediatrics - methods / Pediatrics - organization & administration / Pediatrics - standards / Practice Patterns, Physicians' - standards / Practice Patterns, Physicians' - trends / Societies, Medical - organization & administration / Societies, Medical - standards / Teenagers