小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 黑棘皮症
- 多尿
- 多饮
- 夜尿
其他诊断因素
- 高血压
- 真菌感染
- 皮肤感染
- 泌尿道感染
- 疲劳
- 视力模糊
- 体重减轻
危险因素
- 肥胖
- 遗传倾向/家族史
- 高风险的种族背景
- 青春期
- 女性
- 早产儿
- 婴儿期快速增长
- 糖尿病患者子宫内环境
- 人工喂养
- 婴儿的高蛋白摄取
- 多囊卵巢
- 肌细胞内脂质含量
- 脂肪沉积于肝脏
诊断性检查
首要检查
- 尿试纸试验
- 随机血糖
- 空腹血糖
- HbA1c
- 胰岛素自身抗体、抗胰岛细胞自身抗体、谷氨酸脱羧酶自身抗体、锌转运体 8 自身抗体
需考虑的检查
- 口服葡萄糖耐量检查
- C 肽
治疗流程
酮症
严重高血糖：新诊断
糖化血红蛋白 (HbA1c) 53-86 mmol/mol (7%-10%)
HbA1c>86 mmol/mol (>10%)
撰稿人
作者
Paul Hiers, MD
Pediatric Endocrinology Fellow
Department of Pediatrics
University of Florida
Gainesville
FL
利益声明
PH declares that he has no competing interests.
Jennifer Miller, MD
Assistant Professor
Department of Pediatrics
University of Florida
Gainesville
FL
利益声明
JM is an author of a reference cited in this topic.
鸣谢
Dr Paul Hiers and Dr Jennifer Miller wish to gratefully acknowledge Dr Arlan Rosenbloom, a previous contributor to this topic.
利益声明
AR is an author of a number of references cited in this topic.
同行评议者
Julian P. Hamilton-Shield, MB, ChB, MD(Bristol), MRCP, FRCPCH, FRCPCH
Professor
Diabetes and Metabolic Endocrinology
School of Clinical Sciences
University of Bristol
UK
利益声明
In the past, JPHS received speaking honoraria from Sanofi-Aventis, Roche, Abbott, Novo-Nordisk, and Nutricia. None of these talks were directly pertinent to the treatment of type 2 diabetes.
Kristen Nadeau, MD
Professor of Pediatrics
University of California
Sacramento
CA
利益声明
KN declares that she has no competing interests.
Dennis Styne, MD
Professor of Pediatrics
Rumsey Chair of Pediatric Endocrinology
University of California
Sacramento
CA
利益声明
DS declares that he has no competing interests.
鉴别诊断
- 糖耐量异常
- 1型糖尿病
- 单基因糖尿病
更多 鉴别诊断指南
- 糖尿病医学诊疗标准——2021 年
- 临床指南：2 型糖尿病的全科医学管理（2016-2020
更多 指南患者教育信息
Diabetes: what is it?
Diabetes type 2: what treatments work?
更多 患者教育信息
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