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Pediatric endocrinologists' management of children with type 2 diabetes

Kam Wong1, Amy Potter, Shelagh Mulvaney

  • 1Departments of Medicine and Pediatrics, Vanderbilt University, Nashville, Tennessee, USA.

Diabetes Care
|December 17, 2009
PubMed

Insights

Pediatric endocrinologists show varied adherence to type 2 diabetes guidelines. Younger physicians demonstrate more aggressive management, indicating potential areas for quality improvement in pediatric diabetes care.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management
  • Clinical Practice Guidelines

Background:

  • Type 2 diabetes in children is increasing.
  • Understanding physician management is crucial for optimal care.
  • Current guidelines exist but adherence varies.

Purpose of the Study:

  • To assess pediatric endocrinologists' (PEs) behaviors and attitudes.
  • To identify concordance with type 2 diabetes management guidelines.
  • To explore barriers and factors influencing management.

Main Methods:

  • Nationwide survey distributed to pediatric endocrinologists.
  • Response rate of 40% (211 of 527 PEs).
  • Assessment of guideline concordance via vignettes and self-reported practices.

Main Results:

  • Wide variation in monitoring guideline concordance (36%-93%).
  • Only 34% of PEs fully concordant with treatment guidelines for comorbidities.
  • Barriers include patient adherence concerns and lack of familiarity with recommendations.

Conclusions:

  • Significant variability exists in pediatric type 2 diabetes screening and management.
  • Opportunities for quality improvement in pediatric diabetes care are identified.
  • Younger providers (<45 years or <10 years practice) show higher guideline concordance and more aggressive management.

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