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Type 2 Diabetes Progresses Faster in Children

In addition, complications are appearing faster and at what appear to be a more significant rate….

The study included around 700 children between 10 and 17 years old with type 2 diabetes. Subjects had the disease for 8 months on average. Children under 10 were excluded because it is rare to see type 2 diabetes in that demographic. All participants were overweight with a BMI above the 85th percentile.

Children received diabetes education and were randomized to one of three groups. These groups were either being treated with metformin, metformin plus intensive lifestyle changes, or metformin plus rosiglitazone.

The rate of deterioration of beta cell function in youth was almost four times higher than has been reported in adults, researchers found, noting a 20-35 percent decline in beta cell function per year on average, compared to 7-11 percent for adults (as reported in previous research).

The study followed patients for four years and assessed the complications associated with diabetes. High blood pressure increased 22 percent over the 4 year follow-up period. Additionally, microalbuminuria, an early sign of kidney disease, almost tripled from 6.3 percent to nearly 17 percent. Eye damage seemed to be similar in children and adults.

Researchers found that LDL, triglycerides and other inflammatory markers all rose over 12 months and then stabilized over the next 24 months. The percentage of youth with LDL levels over 130 mg/dl and those needing to be placed on cholesterol-lowering medications once their levels exceeded 130 mg/dl rose from 4.5 percent of participants to 10.7 percent over 36 months.

Experts suspect that the age for kidney transplants will begin to drop. It is essential to push education about preventing diabetes and obesity through implementation of a healthy diet and physical activity.

"The message here is that if you are going to treat youth with type 2 diabetes effectively, it must be done early and aggressively targeting to improve beta cell function and insulin resistance. The development of type 2 diabetes among young individuals has significant public health consequences as these youth are likely to manifest the complications of diabetes, including retinopathy, nephropathy, neuropathy and cardiovascular disease, at a time that should be the most active and productive of their lives," concluded an accompanying commentary by Griffin P. Rodgers, MD, director of the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health, which funded the study, and NIDDK colleagues Barbara Linder, MD, PhD, senior advisor for childhood diabetes research; and Judith Fradkin, MD, director of the Division of Diabetes, Endocrinology and Metabolic Diseases of NIDDK.

Diabetes May, 2013