Type 2 Diabetes in Children and Adolescents.

Type 2 diabetes is a serious and costly disease affecting more than 15 million adult Americans. The chronic complications of diabetes include accelerated development of cardiovascular disease, end-stage renal disease, loss of visual acuity, and limb amputations. All of these complications contribute to the excess morbidity and mortality in individuals with diabetes. Moreover, the prevalence of type 2 diabetes in adults is increasing. Superimposed on this disturbing picture in adults are the recent reports of the emerging problem of type 2 diabetes in children and adolescents. If the incidence and prevalence of type 2 diabetes in children are increasing and if this increase cannot be reversed, our society will face major challenges. That is, the burden of diabetes and its complications will affect many more individuals than currently anticipated, and the cost of diabetes to our society will cause us to consume enormous resources. Also, many more Americans will be taking potent medications, which have attendant risks, for most of their lives. Despite the wealth of experience and knowledge concerning the epidemiology, pathophysiology, and medical management of type 2 diabetes in adults, we know little about the disease in children. To assess our present knowledge and understanding and to provide guidance to practitioners on medical management, the American Diabetes Association (ADA) convened a consensus development conference on type 2 diabetes in children and adolescents from 30 August 1999 to 1 September 1999. An eight-member panel of experts in diabetes in children, complemented by representatives from the National Institute of Diabetes and Digestive and Kidney Diseases, the Division of Diabetes Translation at the Centers for Disease Control and Prevention, and the American Academy of Pediatrics, developed a consensus position on the following six questions:

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