Too many pediatric patients in developed countries are obese. Type 2 diabetes mellitus may occur in obese children, especially those from high risk ethnic groups. The American Diabetes Association (ADA) has developed criteria for identifying high risk pediatric patients who should be screened for Type 2 diabetes.
Criteria for high risk:
(1) obesity as determined by 1 of the following:
(1a) body weight > 120% of ideal weight for height
(1b) body mass index (BMI) > 85th percentile for age and gender
(1c) weight for height > 85th percentile
(2) presence of at least 2 of the following risk factors:
(2a) family history of type 2 diabetes in a first or second degree relative
(2b) member of high risk ethnic group (American Indian, Afro-American, Hispanic/Latino, Asian American, Pacific Islander)
(2c) presence of signs and symptoms of insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, polycystic ovary disease, other)
A patient identified as being at risk should be screened:
(1) starting at 10 years of age or onset of puberty, whichever is earlier
(2) every 2 years thereafter
(3) by measuring the fasting glucose concentration.
