The development of the Guidelines focused on finding answer to four major questions regarding type 2 diabetes in children and adolescents:
How effective are the different treatments?
What are the benefits of the different medications?
When and how to screen for complications and associated conditions?
How should complications and associated conditions be managed?
The quality of research evidence was assessed and graded, and expert opinions were sought where the evidence was incomplete or lacking. Experts in the field of pediatrics and diabetes care and management were invited to review and comment on a draft before the Guidelines was amended and published.
The Guideline consists of six key action statements.
Each statement is accompanied by its own profile that includes explanations of important aspects of the content e.g. quality of evidence, the potential benefit and risk.
1. Insulin should be started if:
• it is unclear whether the child/adolescent has type 1 diabetes or type 2
• the blood glucose level is approximately 14mmol/L or above (250mg/dl), or
• the HbA1c is equal to or above 9% (75mmol/mol)
2. Initiate lifestyle intervention
with nutrition therapy and physical activity after diagnosis and start metformin
3. Monitor HbA1c every 3 months
and intensify targets for self-monitoring blood glucose results if HbA1c recommendations are not met
4. Recommend self-monitoring
of blood glucose if:
• taking insulin or medications that can cause hypoglycaemia
• when starting or changing diabetes treatment
• if treatment goals are not met, and
• during illness
5. Incorporate weight management guidelines
during nutrition counseling recommended at diagnosis and as part of ongoing management.
6. Recommend 60 minutes of moderate to vigorous exercise
every day and limit screen time not connected to school activities to no more than 2 hours per day.
The Guideline stresses the importance of family centered care and appropriate education. The Guideline is designed to assist clinical decision in primary care, not replace clinical judgment. To read or download the Guideline, please click here.
This Guideline should be read in conjunction with other recommendations, protocols and guidelines. Please click here t
o access the Australian diabetes guidelines approved by the National Health and Medical Research Council. To access global diabetes guidelines, please click here
to visit the International Diabetes Federation.
Note; This Guideline was developed by the American Academy of Pediatrics’ in partnership the Pediatric Endocrine Society, American, Academy of Family Physicians, American Diabetes Association and the Academy of Nutrition and Dietetics.