Diabetes Drug Use Triples for Girls

The number of adolescent girls taking drugs for Type 2 diabetes nearly tripled in just five years. The study, an analysis of prescription drug use from 2001 to 2006 among 370,000 insured children aged 10 to 19, was conducted by Medco Health Inc. of Franklin Lakes, N.J., the country’s biggest prescription benefit manager, and released exclusively to The Associated Press.

Experts say the findings raise questions about physical health problems in youth, the appropriateness of putting them on strong, long-term medicines mostly designed for adults, and whether it might be better to focus on other strategies, such as counseling, exercise and changes in diet, caffeine intake and bedtime routine.

"There’s increasing use of medication in children the last 20 years, but does that mean we’re treating them successfully or that we’re overmedicating?" said Dr. Thomas Insel, director of the National Institute of Mental Health. Probably both, he said, but some children aren’t getting needed help.

Dr. Wayne Snodgrass, chairman of the American Academy of Pediatrics’ committee on drugs, said the levels of medication usage found in the study might be appropriate, but it’s hard to know without details on why each prescription was written.
The most striking trend was a 167 percent spike in girls 10 to 19 taking pills for type 2 diabetes, formerly called adult-onset diabetes. Medco found it jumped from 0.1 percent in 2001 to 0.27 percent in 2006; among boys, prevalence up 33 percent, to 0.08 percent.

Dr. John Buse, president-elect of the American Diabetes Association, said those figures are a bit higher than prior data but track U.S. increases in diabetes and obesity the past 15 years.  "It’s really scary to think about people in their teens developing a disease that in the past only developed in the 40s, 50s and 60s," Buse said.

The big gap between the sexes, he said, likely is partly due to girls taking a generic diabetes drug, metformin, linked to weight loss and also prescribed for a hormonal condition that involves abnormal insulin function, causes male sex traits and increases cancer risk. Also, hormone changes in puberty can trigger insulin resistance, or prediabetes. Puberty starts a couple years earlier in girls, so many more girls than boys in the study were in puberty.

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DID YOU KNOW:
Insulin and Low–Glycemic Load vs Low-Fat Diets: Differing physiological characteristics may be an explanation for inconsistent outcomes of dietary interventions for weight loss. Ebbeling and colleagues investigated whether insulin secretion affects weight loss in obese young adults who were randomly assigned to either a low–glycemic load or a low-fat diet. At the 18-month follow-up, the authors found that among participants whose insulin secretion at baseline was above the median, loss of weight and body fat were greater in persons assigned to the low–glycemic load vs the low-fat diet. The low–glycemic load diet was associated with greater improvements in high-density lipoprotein cholesterol and triglyceride levels and the low-fat diet with more improvement in low-density lipoprotein cholesterol levels. See this week’s item # 1   JAMA. 2007;297:2053

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