Posts Tagged ‘youth’

Type 2 Diabetes Harder to Treat in Children

May 1st, 2012

An article by Denise Grady in the New York Times reports on a study that type 2 diabetes in children is harder to treat and more virulent that in adults. The article recounts story of Sara Chernov who learned she had type 2 diabetes when she was 16. “ Her grandfather had had both legs amputated as a result of the disease and one of the first questions she asked was when she would lose her legs and her eyesight. A doctor scolded her for being fat and told her she had to lose weight and could never eat sugar again. She left the office in tears and did not go back.” NYT: Obesity type 2 diabetes worse in children See the article at NEJM: Clinical Trial Glycemic Control in Youth

This is one of those “really bad news” papers. Patients were 10 to 17 years old and treated with metformin to reach a HbA1c level below 8% They were randomized to metformin alone or metformin with rosiglitazone or lifestyle-intervention focusing on weight loss through eating and activity behaviors. Of the 699 participants, only 45.6% reached the primary outcome over an average of 3.86 years of follow-up. Rates of failure were 51% for metformin alone, 38.6% for metformin plus rosiglitazone and 46.6% for metformin plus lifestyle. Metformin alone was least effective in non-Hispanic black participants and metformin plus rosiglitazone was most effective in girls.

Serious adverse events were reported in 19.2% of participants; including 18.1% in the metformin group, 14.6% in the metformin-rosiglitazone group and 24.8% in the metformin plus lifestyle group.

Differences in outcomes were not attributable to adherence or changes in BMI.