Evaluation | Screening approach | Abnormal result | Usual treatment |
Hypertension | Measure BP at each routine visit, with additional visits as needed if BP is elevated. | Adolescents ≥13 years:*[1,2]
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Dyslipidemia | Lipid panel at diagnosis of diabetes, once glycemic control is achieved. If sample was nonfasting (random) and results are indeterminate, confirm with a fasting lipid panel. Repeat annually. | LDL ≥100 to 130 mg/dL (2.59 to 3.36 mmol/L) |
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LDL ≥130 mg/dL (≥3.36 mmol/L) |
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TG ≥150 |
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Nephropathy | UACR (spot specimen). If abnormal, repeat on at least 2 occasions during the next 3 to 6 months. Repeat screening annually. | UACR ≥30 mg albumin/g creatinineΔ |
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Retinopathy | Dilated eye examination or retinal imaging. Repeat annually or as advised by eye care professional. | Nonproliferative, preproliferative, or proliferative retinopathy |
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Neuropathy | Foot examination (pulses and ankle reflex); sensory testing for vibration (tuning fork) and sensation (10 g monofilament). Repeat annually. | Any abnormalities |
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Psychosocial assessment | Screen for depression, eating disorders, family conflict, risk-taking behaviors, or other psychosocial dysfunction. Repeat at each routine visit or as needed. | Clinical symptoms of depression, eating disorder, or psychosocial dysfunction |
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Smoking | Ask about use or experimentation with tobacco products including vaping (e-cigarettes). Provide anticipatory guidance to avoid smoking and vaping. Repeat at each routine visit. | History of smoking or vaping |
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BP: blood pressure; SBP: systolic blood pressure; DBP: diastolic blood pressure; ACE: angiotensin-converting enzyme; ARB: angiotensin receptor blocker; LDL: low-density lipoprotein; TG: triglycerides; UACR: urine albumin-to-creatinine ratio.
* For children <13 years, elevated BP (prehypertension) is defined as BP 90th to 95th percentile and hypertension BP ≥95th percentile. Refer to UpToDate topic and table for American Academy of Pediatrics definitions for pediatric BP categories.
¶ ACE inhibitors (eg, lisinopril or enalapril) and ARBs have teratogenic potential, so appropriate reproductive counseling should be given to young females. Aim for BP consistently <120/80 mmHg (or <90th percentile for children <13 years).
Δ Transient albuminuria is common in children. Abnormal results should be confirmed on at least 2 occasions, ruling out orthostatic albuminuria with a first morning sample, or with a 24-hour urine collection.Do you want to add Medilib to your home screen?