 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Pamella Darby, MPH, RD1, Roy Grant2, Alan Shapiro, MD1, and Irwin Redlener, MD1. (1) Section of Community Pediatrics, The Children's Hospital at Montefiore, 317 East 64th Street, New York, NY 10021, 212-535-9779, pdarby@montefiore.org, (2) The Children's Health Fund, 317 East 64th Street, New York, NY 10021
As the rates of overweight and obesity have increased in children and adolescents so have the rates of type 2 diabetes. Low income and minority populations also have higher rates of both obesity and type 2 diabetes. The Starting Right program’s goals are to develop child-specific protocols for screening patients in primary pediatric care. The first step is encouraging providers to compute Body Mass Index (BMI) for all patients. Next, all children and adolescents at greater than the 85th percentile BMI per age are screened for type 2 diabetes. Early screening and identification allow for intervention at a stage prior to obesity, pre-diabetes and/ or diabetes. All protocols were implemented in a busy, primary care center serving high-risk populations. Almost all patients are from the racial and ethnic groups at highest risk of developing type 2 diabetes. Screening and referral protocols were modified for successful program implementation. Currently all patients at risk of overweight are referred to nutrition counseling. Patients who are at risk of overweight and with two risk factors are then screened for type 2 diabetes. Diabetes screening is coordinated with pediatric endocrinologists, and efforts are made to incorporate as much blood drawing in the primary care setting as is feasible to reduce referrals and possible missed opportunities for testing. Screening and referral protocols for this high-risk population will be shared as will data on the first year of program operation. Data are currently being collected to establish the reliability of this protocol.
Learning Objectives:
Keywords: Diabetes, Obesity
Related Web page: www.childrenshealthfund.org
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.