Type 2 Tough to Treat in Teens

Rosiglitazone to metformin improved diabetic children's blood sugar

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) As childhood obesity becomes more common, so does diabetes in youth. With all the risks linked to diabetes, it is important that these children get their blood sugar under control - a task that is not always easy.

Metformin, one of the most common diabetes drugs, stopped working in about half of children after just a few years of treatment.

These findings suggest that type 2 diabetes may be harder to treat in children and teens.

"Lose weight to prevent the onset of diabetes."

Type 2 diabetes used to be an adult disease. It was hardly ever seen in children. Today, this form of diabetes is still uncommon in children, but the rates are rising.

With this growing problem in mind, Phil Zeitler, M.D., Ph.D., of the University of Colorado Denver, and colleagues carried out the first large study on children with type 2 diabetes.

The researchers wanted to see which of three treatments would work best to help diabetic children bring their blood sugar down to healthy levels. Each child in the study was randomly assigned to take metformin alone, metformin with rosiglitazone (sold as Avandia), or metformin with a lifestyle intervention program that focused on weight loss through diet and exercise.

Metformin is one of the oldest and most commonly prescribed diabetes drugs. It is sold under the brand names Fortamet, Glucophage, Glumetza, and Riomet.

Rosiglitazone, or Avandia, is a drug that works by boosting the body's sensitivity to insulin, a natural hormone that helps control blood sugar levels.

From their study, the researchers found that metformin alone failed to work more often in children than in similar groups of adults.

Their results also show that adding rosiglitazone to metformin improved diabetic children's blood sugar, compared to metformin alone. However, adding a lifestyle intervention program was no better than metformin alone.

According to the authors, "These results suggest that a majority of youth with type 2 diabetes may require combination treatment or insulin therapy within a few years after diagnosis."

Unfortunately, Dr. Zeitler and colleagues were not able to pinpoint why metformin failed so often in young diabetics.

One reason for the failure may be the complex mental and physical changes that teens undergo.

Despite the uncertainty surrounding the failed treatment, it is still possible to prevent type 2 diabetes in young people. Ideally, young people would not have to be treated for diabetes. Families can play a huge role in preventing diabetes by encouraging their children to eat healthy and to exercise. Reducing obesity can reduce rates of diabetes.

The results of this study should encourage scientists to research this topic further. If rates of obesity and diabetes continue to grow among young people, there may be higher rates of diabetes-related complications, such as heart disease, kidney disease, eye problems, nerve damage, and amputations.

This study - which included 699 participants aged 10 to 17 years - was published in The New England Journal of Medicine.

The research was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Center for Research Resources, among others.

Reviewed by: 
Review Date: 
April 30, 2012
Last Updated:
August 22, 2012