April 18, 2023
Parents of a 12-year-old female patient are worried about her getting diabetes. They have noticed that her weight gain has increased over the last couple of years. Both parents have type 2 diabetes and they want to protect her from developing it too.
The patient has a past medical history of allergic rhinitis and obesity. She is not taking any regularly prescribed medications but does take loratadine as needed. There is no family history of autoimmunity.
On physical exam, she has a body mass index 85% above the ideal for her age and gender, blood pressure of 108/78 mmHg, respiratory rate of 16 breaths per minute, and a pulse of 94 beats per minute. She is not in acute distress and has no signs of insulin resistance other than truncal obesity. The rest of her exam is normal including her thyroid exam.