Type-2 Diabetes in Youth is Tougher to Control

Treating diabetes type-2 in teenagers is not simple says a new study published in The New England Journal of Medicine.

The researchers found that just one drug “metformin” was not effective in controlling the blood-sugar. Metformin combined with rosiglitazone (avandia) was better treatment. Even without any lifestyle interventions, the combined treatment worked in controlling diabetes type-2.

For the study, the researchers looked at various treatments to control blood sugar level. 699 obese or overweight and recently diagnosed with diabetes teenagers (10-17 years old) were chosen for the study. All the participants were given metformin to control their blood sugar levels. They were then randomly assigned in three groups.

The first group was kept on metformin; the second on metformin and rosiglitazone ; and the third on metformin and lifestyle intervention. None of the treatments were found adequate and they had a high failure rate

After 4 years it was found that participants in the first group (metformin-only) weren’t able to control their blood sugar level with a failure rate of more than 50 %. The second group (metformin plus rosiglitazone) did better than the first group but did only modestly better than the third (lifestyle-intervention) group. Compared to lifestyle intervention group 46%, nearly 38% of participants on metformin and rosiglitazone failed to keep blood glucose levels at normal levels.

"These kids did not do as well on metformin as anticipated based on our experience in adults. The assumption has been that kids will do fine on metformin, but clearly that is not the case, said Barbara Linder, Phd M.D., of the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) to WebMed.

FDA had restricted use of rosiglitazone in 2010 as research data suggested rosiglitizarone elevated risk of heart-attacks in people who used the drug.

According to Centers for Disease Control and Prevention (CDC), 17 percent or 12.5 million of children and adolescents are obese. Since 1980, obesity prevalence among adolescents has tripled. Low levels of physical activity and increasing obesity major contributors to the increase in number of teenagers diagnosed with type-2 diabetes.

CDC also says that, children and adolescents diagnosed with type 2 diabetes are generally between 10 and 19 years old, obese, have a strong family history for type- 2diabetes, and have insulin resistance. Generally, children and adolescents with type 2 diabetes have poor glycemic control (A1C = 10% - 12%).

The Tribune reports that many participants in the study group were from poor families with 42 percent having an annual income of less than $25,000. More than half of the participants were Hispanics or blacks.