May 2, 2012: Type 2 diabetes, so rare in children it was once called "adult onset," is not only on the increase in children, but it more difficult to treat. It is more than likely, says a new clinical trial, that overweight/obese teenagers who have Type 2, will not be able to control their blood sugar levels. The federally funded findings were published Sunday in the New England Journal of Medicine, and was first reported in the New York Times by Denise Grady. [Emphases ours.]
The study followed 699 children ages 10 to 17 at medical centers around the country and found that the usual oral medicine for Type 2 diabetes stopped working in about half of the patients within a few years, and they had to add daily shots of insulin to control their blood sugar. Researchers said they were shocked by how poorly the oral drugs performed because they work much better in adults.
Nearly half of the 699 newly diagnosed teens failed to control their blood sugar within 4 years and 1 in 5 suffered serious complications.
The clinical study is the first to look at treating teens with diabetes; previous research has focused solely on adults and most diabetes drugs are not approved for pediatric patients.
Co-authors Phillip Zeitler M.D., above, endocrinologist and pediatrician, University of Colorado, andMitchell Geffner M.D., pediatrics professor, the Keck School of Medicine of the University of Southern California, and director of Fellowship Training in the Division of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, treated all the teens with metaformin, a drug to lower blood sugar. Once normalized, the teens were randomly assigned to 3 groups: metformin alone, metformin plus diet and exercise counseling, or metformin plus a second drug, Avandia .
The group who took metaformin only had failure rates of 52%; the group that included lifestyle interventions (diet and exercise) failed in slightly less numbers (47%), while the group that took Avandia had at the lowest failure rates (39%). However, there are many concerns about taking Avandia, as it is not approved for use in children and has been linked to higher risk of heart attacks in adults (which became known after the study began).
... [type 2 diabetes in children] is still uncommon, Grady reported, but experts say any increase in such a serious disease is troubling. There were about 3,600 new cases a year from 2002 to 2005, the latest years for which data is available.
....Why the disease is so hard to control in children and teenagers is not known. The researchers said that rapid growth and the intense hormonal changes at puberty might play a part.