Many Unable to Control HbA1C and Develop Markers of Risk for Cardiovascular Complications

June 9, 2012 (Philadelphia) – Children diagnosed with type 2 diabetes in USA appear to experience a more rapidly progressive disease than people who are diagnosed as adults, with a higher rate of early complications and a relatively early need for combination therapy or insulin, according to research results from the largest, and only, longitudinal study of its kind to date, of children with diabetes, presented in US.

The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study, which was designed to test the efficacy and safety of diabetes medications for young people, was also able to identify which group of children would be able to manage their diabetes and which would face more rapid progression of the disease based on their initial response to metformin treatment. Researchers found that those who had good glycemic control (as evidenced by HbA1C levels in the normal range) after two to four months on metformin during the pre-randomization period were more likely to maintain that control for at least 48 months than those whose HbA1C levels were greater than 6.1 percent after the first few months of treatment on metformin.
“The good news is nearly 50 percent of the kids did well on metformin therapy,” said

Phil Zeitler, MD, PhD, TODAY study Chair and Professor of Pediatrics at the University of Colorado. “For the other 50 percent, we need to focus on what type of treatment is best for them and at this point, the only well-studied option is combination with insulin.”
Initial results from the TODAY study, showing that nearly 50 percent of youth with type 2 diabetes needed insulin therapy within a few years of diagnosis.

“The biggest concern with diabetes is the consequences in terms of cardiovascular disease and microvascular disease and these kids are at very high risk at young ages,” Zeitler said. “Within the next 10-20 years, many of these kids will have substantial health problems. This suggests a major health burden in the future.”

The TODAY study looked at 699 youth with type 2 diabetes at 15 health centers across the U.S., with a follow- up period of two to six years. Patients were between 10 and 17 years old when entered into the study and had been diagnosed within the past two years.

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