Type 2 diabetes difficult to treat in children

LOS ANGELES

Children's Hospital Los Angeles was one of 14 sites that followed 700 10 to17 year olds for nearly four years. The children participated in a trial known as the Treatment Options for Type 2 Diabetes in Adolescents and Youth.

One group took the diabetes drug metformin. The second took metformin and followed a strict diet and exercise plan. The third took two drugs, metformin and rosiglitazone.

The results: none of the groups did well.

"The results were both incredibly interesting, in part disappointing," said Dr. Lynda Fisher.

The kids on metformin alone had a much higher failure rate than in adults. Forty-six percent of those who changed their lifestyle ended up on insulin, as did 38 percent who took the two drugs.

Why the disease is so hard to control in children and teenagers is not known, but study authors suspect rapid growth and intense hormonal changes at puberty might play a role.

"Puberty is a time of great insulin resistance," Fisher said. "Insulin resistance is a big piece of Type 2 diabetes.

The bottom line is that Type 2 diabetes is difficult to treat in the young, so more emphasis needs to be placed in preventing it in early childhood.

Dr. Fisher added that Latinos and African Americans did worse on medications than White participants. And at-risk populations face many more challenges, including affording healthier foods and access to healthcare

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