Xu · American family physician 2018 · narrative review · n=?

Type 2 Diabetes Mellitus in Children.

Cited 21 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative clinical review summarizing practice guidelines without systematic review methodology.

PubMed 30325644 · record verified 2026-08-28

What was done

Narrative review of clinical screening recommendations, diagnostic criteria, and management approaches (primarily from the American Diabetes Association) for type 2 diabetes mellitus in children and adolescents.

What was found

Screening is recommended starting at age 10 or puberty onset for overweight/obese youth with at least two risk factors. Diagnostic thresholds are: fasting plasma glucose ≥126 mg/dL, 2-hour post-OGTT plasma glucose ≥200 mg/dL, A1C ≥6.5%, or random plasma glucose ≥200 mg/dL with symptoms (polyuria, polydipsia, weight loss). First-line pharmacological treatment is metformin combined with nutrition and exercise counseling. Insulin is indicated for ketosis/ketoacidosis, A1C >9%, or random plasma glucose ≥250 mg/dL. The abstract reports no empirical outcome statistics or comparative effect sizes.

Why it matters

It outlines clear diagnostic and therapeutic thresholds to guide primary care clinicians managing pediatric type 2 diabetes in the context of rising childhood obesity.

Limits

As a narrative review, it reflects clinical guidelines rather than primary experimental data or systematic synthesis. The abstract provides no quantitative data on treatment efficacy, adherence rates, or long-term clinical outcomes.

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