The increasing prevalence of obesity among children and teenagers is having unavoidable consequences on their health. One of these is that a diagnosis of type 2 diabetes is no longer a rare occurrence in pediatric medicine. Unfortunately, clinicians do not have access to much information on the safest and most effective treatment strategies for these young patients.
Type 2 diabetes develops when the pancreas becomes overworked and is no longer able to produce the necessary insulin, or cells in the body become resistant to the action of insulin. This usually develops after the age of 40 and is more common among overweight individuals.
More and more young people who are obese and sedentary are being diagnosed with type 2 diabetes. To better understand the progression of the disease in these patients, researchers recruited nearly 700 people between the ages of 10 and 17 who had type 2 diabetes. The participants were taking metformin, the usual first-line treatment in adults with the disease. They were split into three groups: group 1 continued the metformin treatment, group 2 took an additional medication (rosiglitazone), and group 3 took part in a program designed to improve their lifestyle in order to reach a healthy body weight.
Fewer than half the participants (45.6%) achieved the target blood glucose levels. Those who did achieve them managed to maintain those levels for an average of 3.7 years. Adding a second drug resulted in better glycemic control, but was associated with weight gain. Taking part in a healthy lifestyle program only had a minor impact on controlling the disease.
The researchers noticed that the treatment became ineffective sooner in young people than in adults. As a result, the study suggests that a few years after they are diagnosed, most young people are likely to need more than one antidiabetic drug or to need to begin insulin therapy.
The risk of diabetes-related complications in adulthood increases with the disease duration and poor glycemic control. It is therefore essential that approaches be developed to prevent and treat diabetes in young people in order to preserve their long-term quality of life.