Type 2 Diabetes Referral Guidelines

An initial screening is recommended for children with BMI above the 85th percentile with a fasting or random blood glucose and/or HbA1c. Screening is recommended yearly or sooner if BMI is increasing or if there are symptoms of diabetes (polyuria/polydipsia, unexplained weight loss, fatigue). 

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.

• Refer to a dietician if FGB <99 and HbA1c <6.0%
• Refer to a prediabetes clinic, non-urgent appointment, if FBG 100-125 and HbA1c 6.0-7.0%
• Refer to Type 2 diabetes clinic, expedited appointment will be given, if FBG ≥126, random BG ≥200, HbA1c ≥7.0%
• If blood glucose is more than 200, check for urine ketones, and call office department for urgent referral.

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 at 202-476-5000 and ask for the endocrinologist on call.

A patient should expect to meet with endocrinologist and dietitian at their visit. They may also meet with a diabetes educator.

If required, an appointment with a psychologist will be scheduled.