The multiple indications for growth hormone treatment of pediatric patients.

GH has many approved uses in pediatric patients including GH deficiency, CRF, Turner syndrome, Prader-Willi syndrome, SGA, and ISS. The child should have an appropriate evaluation for poor growth and endocrine consultation as dictated by clinical and investigative findings. Treatment of the child with GH deficiency is universally accepted.

Puberty: timing is everything.

When evaluating delayed puberty, it is essential to determine the underlying cause. This can be done with history and physical exam as well as basal gonadotropin levels, bone age, and further testing as indicated. When the cause is hypogonadism, an underlying condition should be treated if present; otherwise lifelong hormonal therapy is necessary.

Type 2 diabetes mellitus in youth.

In the United States, the incidence of type 2 diabetes mellitus (DM) in children and adolescents has been increasing at an alarming rate. Early recognition and intervention can delay the onset of type 2 DM and prevent the long-term complications. School nurses have an essential role in implementing the American Diabetes Association (ADA) recommended screening guidelines to identify youth at high risk for type 2 DM and in implementing student health programs that focus positively on the importance of physical activity and healthy eating habits.

Type 2 diabetes mellitus in adolescents.

While diabetes mellitus types 1 and 2 used to be distinguished largely by age at onset, in the past decade there has been an increase in the number of children presenting with diabetes that can be controlled with oral medications. This has lead to these children being diagnosed with type 2 diabetes mellitus despite their young age. This chapter offers an overview of presenting features, pathophysiology, treatment and prognosis of this disorder in the adolescent patient.