Study reveals type 2 diabetes may be more aggressive in children
Data shows that the prevalence of type 2 diabetes in children is increasing -- and quickly. Now, new research suggests that the disease may actually be more aggressive in children, too, with serious complications arising just a few years following diagnosis.
Medscape reports that a series of new papers released as part of the ongoing Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study suggest that some youths with type 2 diabetes have a more aggressive form of the disease than adults typically do, and that they are at especially high risk for serious complications, including early renal and cardiovascular disease.
"Based on the latest results, it seems like type 2 is progressing more rapidly in children," Dr. Jane Chiang, senior vice president of medical affairs and community information for the American Diabetes Association, told HealthDay. "Complications are appearing faster, and it appears to be at a more significant rate than we see in adults."
According to HealthDay, the TODAY study followed approximately 700 children between the ages of 10 and 17 who have type 2 diabetes. All participants had a body-mass index that classified them as "overweight." The children received diabetes education and were randomized to receive one of the following treatments: the drug metformin, metformin plus rosiglitazone or metformin plus significant lifestyle changes. After four years, researchers determined that only children taking metformin and rosiglitazone saw an increase in insulin sensitivity; patients in the two remaining groups either experienced no change in insulin sensitivity, or saw it decline.
Researchers also identified other alarming trends. The initial signs of kidney disease almost tripled from 6.3 percent of children to almost 17 percent, for instance, and destruction of insulin-producing beta cells occurred at a rate nearly four times higher than is typical in adults.
"The rapid progression of hypertension and kidney disease was surprising," Dr. Jane Lynch, lead author of the hypertension and kidney disease part of the study, told HealthDay. Lynch said researchers believe hormonal changes related to puberty, which can cause insulin resistance, probably contribute to the accelerated profession of type 2 diabetes in children, and it remains unclear what will happen once they are post-pubescent. "We don't know what the progression rates will be," she said. "But we do know that the ages for kidney transplants have been dropping."
The American Diabetes Association reports that the number of American children diagnosed with type 2 diabetes is growing, and that being overweight is the most significant risk factor for the disease.
Readers can learn more about the TODAY Genetics Study on ClinicalTrials.gov, a publication of the National Institutes of Health. The most reports discussed here were also published in a special edition of the ADA journal Diabetes Care.
"Preventing Type 2 in Children," diabetes.org
"TODAY Study Sounds Alarm Bell for Youth with Type 2 Diabetes," medscape.com, May 23, 2013, Marlene Busko
"The Changing "Face" of the Type 2 Diabetes Epidemic," diabetesjournals.org, May 23, 2013
"Treatment Options for Type 2 Diabetes in Adolescents and Youth (Today)," clinicaltrials.gov
"Type 2 Diabetes Progresses Faster in Kids, Study Finds," healthday.com, May 23, 2013, Serena Gordon
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