Diabetes Prescriptions for Kids Doubled in 4 Years

First study to show the dramatic increase in children with type 2 diabetes. By examining the number of prescriptions for type 2 diabetes drugs taken by children ages 5–19 years, which doubled between 2002 and 2005. This information comes from an analysis by one of the nation’s largest pharmacy benefit–management companies.
A review of 3.7 million prescription claims by Express Scripts revealed that the use of drugs usually indicated for treating type 2 diabetes rose from 0.3 to 0.6 per thousand among children, according to family physician Ed Weisbart, MD, the company’s chief medical officer.

"This study surprised us, how striking the results were," Weisbart says. "We thought there’d be some increase [of diabetes drugs], along with the growth of childhood obesity. But nobody has shown the explosive growth in diabetes. We’ve been expecting it, but this is the first [study] to demonstrate it."

The increase in the use of diabetes drugs was most pronounced in children 10–14 years, rising 106% during the study period. Treatment for type 2 diabetes was most prevalent among those 15–19 years, growing from 0.6 to 1.2 per thousand, according to the analysis.

To focus on type 2 diabetes, the analysis eliminated cases involving injectable insulin and other drugs typically prescribed for type 1 diabetes. Although the percentage increase may seem small, in absolute numbers it is enormous because of the millions of children covered by Express Scripts benefits.

"A doubling of the prevalence of the use of a drug in 4 years is uncommon," Weisbart says, "unless it’s a new drug on the market, like when the erectile dysfunction drugs first came out."

If anything, the prescription data underestimate the prevalence of type 2 diabetes in children, since the disease often is undiagnosed for 5–10 years, and many prescriptions are written for patients but not filled, Weisbart says.

The next phase of the study, expected within a few years, may show an increase in drugs prescribed for treating diabetes-related complications. "We’ve seen the increase in childhood obesity and now an increase in diabetes," Weisbart says. "The third wave of data is going to be the complications of obesity, and that’s when the costs really skyrocket."

The analysis was part of Express Scripts’ routine data mining activities to identify trends and waste.
Express Scripts News Release May, 2006

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