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Good Morning!. July 8 th 2010. Risk Factors. Obesity Positive Family History Specific Ethnic Groups Gender Conditions with Insulin Resistance Puberty PCOS. Presentation. DKA Or with only ketonuria Symptomatic without ketonuria or acidosis Asymptomatic. Diagnosis. HbA1C ≥6.5%

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  1. Good Morning! July 8th 2010

  2. Risk Factors • Obesity • Positive Family History • Specific Ethnic Groups • Gender • Conditions with Insulin Resistance • Puberty • PCOS

  3. Presentation • DKA • Or with only ketonuria • Symptomatic without ketonuria or acidosis • Asymptomatic

  4. Diagnosis • HbA1C • ≥6.5% • FPG • ≥126 mg/dL • OGTT 2 hour • ≥ 200mg/dL • Random • ≥ 200mg/dL

  5. A1C • Fasting • 100-125 IFG • OGTT

  6. Comorbidities Hypertension Dyslipidemia Nonalcoholic fatty liver disease

  7. Hypertension • Pre-Hypertension • ≥90th and <95th %ile or >120/80 • Hypertension • > 95th %ile or >130/80 • Systolic and/or diastolic • 3 separate occasions • Goal <90%ile

  8. Dyslipidemia • Increased triglycerides • Goal <150 • Decreased HDL • Goal >35 • Increased LDL • Goal <100

  9. Other • NAFLD • Most common cause of liver disease in children • Vascular • Not known yet in children • Retinopathy, nephropathy, neuropathy

  10. Treatment Goals To achieve and maintain near-normal glycemic control To improve insulin sensitivity and secretion, which results in improved glycemic control. To identify and treat, if necessary, comorbidities, such as hypertension, dyslipidemia, and nonalcoholic fatty liver disease To prevent the vascular complications of type 2 diabetes

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