Diagnosis, treatment and prevention of type 2 diabetes mellitus in children and adolescents

Table 2 Routine monitoring of children and adolescents with type 2 diabetes for comorbidities and chronic complications

Evaluation	Test performed	Testing frequency
Hypertension	BP measurement with appropriately-sized cuff	At the time of diagnosis and at each routine visit; more frequently if elevated
Dyslipidemia	Non-fasting or fasting lipid panel	At diagnosis once glycemic control is achieved. Annually thereafter, more frequently if abnormal
NAFLD	Liver transaminases	At diagnosis and annually thereafter
Retinopathy	Dilated eye examination or retinal imaging	At diagnosis and annually thereafter, or as per ophthalmologist’s advice
Nephropathy	In a spot specimen urine albumin-to-creatinine ratio	Repeat annually. If abnormal, repeat on at least two occasions during the next 3-6 mo
Neuropathy	Foot examination (pulses and ankle reflex); sensory testing for vibration (tuning fork) and sensation (10-g monofilament)	Repeat annually. If abnormal, refer to neurologist
Psychosocial assessment	Screen for depression, eating disorders, risk-taking behaviors, or other psychosocial dysfunction	Repeat at each routine visit or as needed. If abnormal, refer to mental health professionals

BP: Blood pressure; NAFLD: Non-alcoholic fatty liver disease.