Obesity, Metabolic syndrome and Type 2 Diabetes Mellitus. Learning Objectives: history of obesity and type 2 diabetes. Mother diagnosed with GDM at age 25 …
4:00 5:00 pm
Friday, April 29 Concurrent Workshop
Diabetes
Heather Dean, MD
Obesity, Metabolic syndrome and Type 2 Diabetes Mellitus Learning Objectives: At the end of this session, participants should be able to: 1 Use a BMI curve for children and adolescents 2 Define obesity in children 3 List 3 endocrine causes of obesity in children and clinical characteristics of each 4 List 7 metabolic complications of obesity in children 5 List the criteria to define the metabolic syndrome in children 6 Define screening criteria for type 2 diabetes in children 7 Identify sources of help for promotion of health body weight in children Extra: List 5 measures to measure insulin resistance in children List 5 techniques for measuring body composition in children CASE1 12 year old aboriginal male presents with concerns about excess weight He has been overweight for years Food history shows high fat, high caloric intake Watches TV 5 hours per day No past history of serious medical or surgical illness No history to suggest sleep apnea No medications, alternative medications, herbs or vitamins School performance average Strong family history of obesity and type 2 diabetes Mother diagnosed with
GDM at age 25 and then permanent diabetes at age 30 Is taking insulin No family history of early CVD, renal or liver disease On examination: Height50ile, weight95th ile, BMI95th ile BP 100/65, HR80, severe acanthosis nigricans Investigations: TSH 32 mU/L, TC 35 mmol/L, Tg 12 mmol/L, FBG 68 mmol/L, rACR 30, ALT 125 U/L, AST 97 U/L Questions: 1 What is your problem list? 2 Should he have an oGTT? What if the 2 hour post 75g glucose is 14? 3 How would you advise the family?
CASE2 15 year old aboriginal male presents with concerns about excess weight He has been overweight for years Food history shows high fat, high caloric intake Watches TV 5 hours per day No past history of serious medical or surgical illness No history to suggest sleep apnea Smoking ppd No medication, alternative medications, herbs or vitamins School performance average Strong family history of obesity and type 2 diabetes Mother diagnosed with GDM at age 25 and then permanent diabetes at age 30 Is taking insulin Father diagnosed with type 2 diabetes at age 40 years 2/4 grandparents have type 2 diabetes There are 5 sibs age 6-17 years No family history of early CVD, renal or liver disease On examination: Height50th
ile, weight95th ile, BMI95th ile BP 100/65, HR8-, severe acanthosis nigricans of neck Investigations: TC 56 mmol/L, Tg 28 mmol/L, FBG 150 mmol/L, HgbA1c 11, rACR 52, ALT 69 U/L, AST 55 U/L Questions: 1 What is your problem list? 2 How would you advise the family?
Source:idfpr.com
