Type 2 Diabetes Referral Guidelines
Prediabetes and Type 2 diabetes present with elevated blood glucose. Unlike patients with Type 1 diabetes who have deceased insulin production, patients with prediabetes and Type 2 diabetes have high insulin levels in order to overcome underlying insulin resistance.
Prediabetes and diabetes are not completely separate entities, but more of a spectrum of the same condition cause by insulin resistance and relative beta cell failure. Patients with prediabetes are able to have increased insulin production, which allows them to maintain blood glucose below diabetes range. Overtime the beta cells fail, insulin production decreases and blood glucose rises progressively into the diabetes range.
Risk factors include being overweight or obese, a family history of diabetes, a mother with gestational diabetes during the child’s pregnancy, an at-risk ethnic background and signs of insulin resistance such as acanthosis nigricans.
Diagnosis is made based on blood glucose levels and HbA1c.
Referral Guidelines
Initial management includes weight management, which is crucial in the treatment of prediabetes and diabetes. Providers should encourage families to follow standards for exercise and nutrition, or refer to a nutritionist if needed.
Metformin is the first line of therapy for patients with prediabetes who fail lifestyle intervention and for those with Type 2 diabetes.
How can I refer my patient?
Fax lab results and growth chart to 202-476-4095 with contact information for the family. Our office will contact the family to set up the appointment.
If an expedited appointment is required, call 202-476-5000 and ask for the endocrinologist on call.
Outpatient Appointment Referral Pads
Children's National Hospital offers convenient outpatient locations for specialty care. To help connect your patients with our specialists, please complete the form to request a referral pad from your physician liaison.