Date of Submission

Fall 11-9-2020

Document Type

Manuscript

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Dr. Alexa Curtis

Abstract

The incidence and prevalence of diabetes in youth in the United States is increasing. In particular, type 2 diabetes mellitus (T2DM) is becoming more common in individuals younger than 20 years. Nurse practitioners and other primary care providers that see children should be knowledgeable about the condition and confident in participating in multidisciplinary management. Screening should begin at age 10 or at puberty, whichever comes first. Providers should screen all children who are overweight or obese or of Native American, African American, Latino, Asian American, or Pacific Islander race or ethnicity. Children of these ethnicities have a greater risk for developing T2DM. Screening and diagnostic tests include fasting plasma glucose, the oral glucose tolerance test, and hemoglobin A1C. Once T2DM is diagnosed, management should focus on intensive lifestyle changes and weight loss with dietary changes and increased physical activity. Initial pharmacological treatment involves an oral antihyperglycemic agent and/or subcutaneous insulin therapy. Effective management of a child or adolescent with diabetes involves the creation of a multidisciplinary team consisting of an endocrinologist, social worker, diabetic educator, dietician, school personnel, psychologist, and the family. The family should participate in all aspects of care and commit to making lifestyle changes with the patient. As most youth diagnosed with T2DM are adolescents, they should be encouraged to practice independent care to enable successful transition to young adulthood. Providers should practice culturally sensitive care and individualize treatment and management plans for each patient.

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