SUMMARY
The clinical practice guideline that this technical report accompanies provides evidence-based recommendations on the management of patients between 10 and 18 years of age who have been diagnosed with T2DM. The document does not pertain to patients with im- paired glucose tolerance, isolated in- sulin resistance, or prediabetes, nor does it pertain to obese but nondiabetic youth. It emphasizes the use of man- agement modalities that have been shown to affect clinical outcomes in this pediatric population. The clinical prac- tice guideline addresses situations in which either insulin or metformin is the preferred first-line treatment of chil- dren and adolescents with T2DM. It suggests integrating lifestyle mod- ifications (ie, diet and exercise) in con- cert with medication rather than as an isolated initial treatment approach. Guidelines for frequency of monitoring HbA1c and finger-stick BG concen- trations are presented. The clinical practice guideline is intended to assist clinician decision-making rather than replace clinical judgment and/or es- tablish a protocol for the care of all children with this condition. These rec- ommendations may not provide the only appropriate approach to the manage- ment of children with T2DM. Providers should consult experts trained in the care of children and adolescents with T2DM when treatment goals are not met or when therapy with insulin is initiated.