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Primary Care and Public Health Considerations

David S. Ludwig, MD,PhD; Cara B. Ebbeling, PhD

JAMA. 2001;286:1427-1430.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Historically, diabetes mellitus has been classified as either juvenile-onset (now known as type 1) or adult-onset (type 2) due to distinct differences in the usual age of presentation of these 2 conditions. With the increasing prevalence of type 2 diabetes mellitus in children, these terms have become inaccurate. Recent estimates suggest that type 2 diabetes mellitus may now account for as many as half of all new cases of diabetes in certain pediatric populations. This apparent epidemic, attributable largely to the increased rates of obesity in children, carries enormous long-term public health implications. This article will consider these implications, examine the pathophysiology of type 2 diabetes mellitus in children, and review prevention and treatment strategies.

Epidemiology

There are currently no nationwide epidemiological data focusing on type 2 diabetes mellitus in children, however, clinic-based reports and regional studies consistently emphasize the increasing prevalence of . . . [Full Text of this Article]

Natural History

Complications

Diagnosis

Prevention and Treatment

Weight Loss

Dietary Composition

Physical Activity

Pharmacologic Agents That Increase Insulin Sensitivity

Pharmacologic Agents That Increase Insulin Levels

Conclusion

Author Affiliation: Department of Medicine, Children's Hospital, Boston, Mass.

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