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Marcia M. Ditmyer, PhD, CHES; James H. Price, PhD, MPH; Susan K. Telljohann, HSD, CHES; Francis Rogalski, MD, PhD

Arch Pediatr Adolesc Med. 2003;157:913-918.

Objective  To assess pediatricians' perceptions and practices regarding the prevention and treatment of type 2 diabetes mellitus in children and adolescents in a cross-sectional study.

Design  A 3-wave mailing of a questionnaire to 550 pediatricians. Descriptive statistics, analysis of variance, and logistic regression were used for data analyses.

Setting  A national random sample of pediatricians who work in private practice, hospital settings, and/or clinics.

Results  Every 1 in 9 respondents referred their patients with type 2 diabetes mellitus for exercise, while most pediatricians referred their patients for dietary interventions (62.3%) and educational services (62.6%). Pediatricians who were confident during counseling and follow-up were significantly (P = .02) more likely than pediatricians who were less confident to refer their patients for exercise, dietary interventions, and educational services. Of the respondents, 15.3% perceived they were well prepared to counsel and provide follow-up to patients with type 2 diabetes mellitus. The leading perceived barriers to counseling and follow-up were inadequate time for counseling, poor adherence of patients, lack of family support, lack of familiarity of clinical practice recommendations, and lack of health care insurance coverage.

Conclusions  Pediatricians who had a higher perceived confidence level and who perceived they were better prepared for the counseling and follow-up of patients with type 2 diabetes mellitus had a greater potential to positively affect their diabetic patients. Improving continuing medical education and residency-based programs is imperative to adequately address the emerging epidemic of type 2 diabetes mellitus in children and adolescents.

From the Department of Public Health, The University of Toledo (Drs Ditmyer, Price, and Telljohann), and the Department of Pediatrics, Medical College of Ohio (Dr Rogalski), Toledo, Ohio. Dr Ditmyer is now an adjunct professor with the Department of Health Sciences, University of Nevada, Las Vegas.

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