Chapter 6: Pharmacological Management: Type 2 Diabetes in Children, 2nd Edition 3 Contact Hours
By: Danielle McDonald, PharmD, BCPPS Author Disclosure: Danielle McDonald, and Colibri Healthcare, LLC do not have any actual or potential conflicts of interest in relation to this lesson. Universal Activity Number UAN: #0607-0000-23-003-H01-P Target Audience: Pharmacists in a community-based setting. To Obtain Credit: A minimum test score of 75 percent is needed to obtain a credit. Please submit your answers either by mail, fax, or online at EliteLearning.com/Book Questions regarding statements of credit and other customer ser- vice issues should be directed to 1-888-666-9053. This lesson is $19.95. Activity Type: Knowledge-based Initial Release Date: 4/13/2023 Expiration Date: 4/13/2026 Learning objectives After completing this course, the learner should be able to: Identify the pathophysiology and risk factors for development of type 2 diabetes. Interpret diagnostic criteria of type 2 diabetes in comparison with type 1 diabetes in pediatric patients. Select goals of therapy for managing type 2 diabetes.
Colibri Healthcare, LLC is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Participants of the session who complete the evaluation and provide accurate NABP e-Profile information will have their credit for 3 contact hours (0.3 CEU) submitted to CPE Monitor as early as within 10 business days after course completion and no later than 60 days after the event. Please know that if accurate e-Profile information is not provided within 60 days of the event, credit cannot be claimed after that time. The participant is accountable for verifying the accurate posting of CE credit to their CPE Monitor account within 60 days.
Apply nonpharmacologic recommendations to care of a pediatric patients diagnosed with type 2 diabetes. Choose appropriate pharmacologic therapy for a pediatric patient diagnosed with type 2 diabetes. Recognize psychosocial barriers to success in the treatment of type 2 diabetes in pediatric patients.
INTRODUCTION
Type 2 diabetes mellitus (T2DM), also previously called adult-on- set diabetes or noninsulin-dependent diabetes, is the most com- mon type of diabetes in the U.S. (Centers for Disease Control and Prevention [CDC], 2022a). While commonly used colloquially, the previous misnomers do not fully describe the age range or current scope of treatment of T2DM. In recent years, the onset of T2DM in childhood and adolescence has become more common, and in certain patients, glycemic control may not be achievable without insulin. The prevalence of T2DM in pediatric patients is rising, so pediatric providers must be well versed in the ways in which pre- sentation and management differ from both T1DM in children and Case study: Billy Billy is a 15-year-old male presenting to his pediatrician’s office for an annual visit. All his vital signs are appropriate for his age, including blood pressure, heart rate, and respiratory rate. He has no current complaints and feels in decent physical condition. For years, Billy has struggled with unhealthy eating habits at home, and since the onset of the pandemic, he has not been involved in the sports he once loved to play. His body mass index is consis- tently above the 95th percentile for his age. On the physical exam, he has darkening skin folds around his neck but no other rashes or
T2DM in adults. Adult management cannot be easily extrapolated to care of children, and knowledge of pediatric-specific treatment and prevention is imperative for chronic care of this population. Physicians, nurses, and pharmacists are all well positioned to man- age pediatric patients with T2DM. In this course, the healthcare professional will learn about the diagnosis and management of T2DM, including special considerations related to lifestyle man- agement and newly approved pharmacologic options. Pediatric psychosocial challenges will also be addressed, along with guid- ance for management. notable skin issues. He is not currently on any medications other than a multivitamin. The only pertinent item in his medical history is snoring, but he has never had a sleep study. His immunizations are all up to date, including his annual influenza vaccine. He has never had any surgeries or overnight hospital stays. His parents are both overweight, and his father has type 2 diabetes. He lives at home with both parents and his younger sister. He attends a local public high school and screens negative for any concerning psychosocial issues. Epidemiology Diabetes is one of the most common disease states in adults and children in the U.S. (CDC, 2022a). In the pediatric population, T1DM is more prevalent than T2DM, but T2DM is on the rise. The Centers for Disease Control and Prevention estimate there are 5,700 new T2DM diagnoses among children and adolescents 10 to 19 years of age per year. It is estimated that the prevalence of T2DM in this age group will quadruple in 40 years (ADA et al., 2022g). In recent years, rates have especially been increas- ing among non-Hispanic Black children. Prediabetes, which is the presence of impaired glucose tolerance without the diagnosis of
OVERVIEW OF PEDIATRIC DIABETES
Pediatric diabetes is traditionally attributed to type 1 diabetes mellitus (T1DM), which is an autoimmune process that leads to destruction of pancreatic ß cells (American Diabetes Association [ADA] et al., 2022a). This process results in absolute insulin defi - ciency, and onset is typically in childhood. In recent years, child- hood-onset T2DM has become more prevalent. The pathophys- iology and progression of this disease state differ considerably from T1DM. In T2DM, insulin secretion from ß cells is reduced progressively. This is often termed insulin resistance and can progress over time to insulin deficiency with management and complications similar to T1DM.
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Book Code: RPUS3024
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