Pediatric endocrinologists' management of children with type 2 diabetes.

Wong K, Potter A, Mulvaney S, Russell WE, Schlundt DG, Rothman RL
Diabetes Care. 2010 33 (3): 512-4

PMID: 20007947 · PMCID: PMC2827499 · DOI:10.2337/dc09-1333

OBJECTIVE To understand physician behaviors and attitudes in managing children with type 2 diabetes. RESEARCH DESIGN AND METHODS A survey was mailed to a nationwide sample of pediatric endocrinologists (PEs). RESULTS A total of 40% of PEs surveyed responded (211 of 527). Concordance with current monitoring guidelines varied widely, ranging from 36% (foot care) to 93% (blood pressure monitoring). Given clinical vignettes addressing hyperlipidemia, hypertension, and microalbuminuria, only 34% of PEs were fully concordant with current treatment guidelines. Reported barriers included concerns about patient adherence, insufficient scientific evidence about treatment, and lack of familiarity with current recommendations. Providers aged < or =45 years or in clinical practice <10 years reported significantly more aggressive management behaviors and had higher concordance with guidelines. CONCLUSIONS Screening and management of pediatric type 2 diabetes varied widely among PEs, suggesting opportunities for quality improvement. More aggressive management of type 2 diabetes among younger providers may be related to recent training when type 2 diabetes was more common.

MeSH Terms (14)

Adolescent Adult Child Data Collection Diabetes Mellitus, Type 2 Endocrinology Female Guideline Adherence Humans Male Middle Aged Pediatrics Professional Competence Professional Practice

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