If goals are not met by lifestyle changes, pharmacotherapy is indicated.
Use of oral agents, particularly metformin, is preferred for glucose control before insulin therapy, although only insulin is approved by the US Food and Drug Administration for use in children.
Insulin treatment may be the most effective option for very symptomatic patients or those with very high blood glucose levels.
Angiotensin-converting enzyme inhibitors are recommended for microalbuminuria.
For diabetes prevention in children and adolescents, only lifestyle changes (diet, exercise) are recommended, not pharmacotherapy.
American Diabetes Association. Standards of medical care in diabetes—2009. Diabetes Care. 2009;32(suppl 1):S13-S61.
American Diabetes Association. Type 2 diabetes in children and adolescents (consensus statement). Diabetes Care. 2000;23:381-389.
