Type 2 diabetes progresses more rapidly and is harder to treat in children than in adults, shows a new Massachusetts General Hospital diabetes center study. Although the incidence of type 2 diabetes in children was extremely rare before 1990, between 2002 and 2005 3,600 new cases were diagnosed. The study of nearly 700 10- to 17-year-old overweight or obese patients with type 2 diabetes found that oral diabetes medications were ineffective in nearly half of the patients after a few years. The children and their parents or guardians all received diabetes education. One group took metformin (Glucophage), another group took both metformin and rosiglitazone (Avandia), and a third group took metformin and followed a strict weight-loss program. All three approaches failed to control the patients’ blood sugar. It is possible that rapid growth and hormonal changes of puberty make controlling diabetes more difficult. Poorly controlled type 2 diabetes and having diabetes for a longer time significantly increases complications such as heart disease, kidney failure, nerve damage, and eye problems. Aggressive treatments can help lower these risks. The study participants were largely from low-income families, with 40 percent Hispanic and 33 percent Black children. Rates of diabetes and obesity among both children and adults are highest among poor people and minority groups. Unless obesity rates can be effectively lowered among young people, there will be an increased incidence of type 2 diabetes among young people, requiring better treatments. Currently, the best strategy is to use insulin as soon as metformin fails to control a young person’s blood sugar levels.
