ABSTRACT
The medical community faces an emerging epidemic of type 2 diabetes (T2DM) in children and adolescents with a disproportionate increase among certain ethnic groups. T2DM represents one arm of the metabolic syndrome and parallels an increasing prevalence of obesity. The metabolic syndrome includes insulin resistance, hyperlipidemia, and hypertension with a consequent risk of early cardiovascular disease. Thus, treatment of T2DM and the metabolic syndrome pose a challenge for pediatric endocrinologists and represent an enormous public health issue. This review presents information about the treatment of childhood T2DM.
Subject(s)
Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/drug therapy , Adolescent , Algorithms , Child , Diabetes Mellitus, Type 2/classification , Diabetes Mellitus, Type 2/physiopathology , Humans , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic useABSTRACT
Two infants with congenital syphilis and persistent hypoglycemia were found to have hypopituitarism. Hypopituitarism should be recognized as a potential complication of congenital syphilis; affected infants with persistent hypoglycemia should receive a prompt evaluation of pituitary function.
Subject(s)
Hypoglycemia/etiology , Hypopituitarism/complications , Infant, Premature, Diseases/diagnosis , Syphilis, Congenital/complications , Humans , Hypopituitarism/diagnosis , Infant, Newborn , Infant, Premature , MaleABSTRACT
Symptoms and laboratory evidence of adrenal suppression developed in 2 children with the human immunodeficiency virus after megestrol acetate (MA) therapy was discontinued; both required transient glucocorticoid replacement therapy. High-dose corticotropin stimulation testing performed on children with the human immunodeficiency virus treated or not treated with MA showed that baseline and post-corticotropin cortisol levels were extremely low in 7 of 10 treated patients and normal in 10 of 10 members of a control group (P <.01). MA may suppress adrenal function, and replacement glucocorticoids may prevent or relieve associated symptoms at times of severe stress or on discontinuation of MA therapy.