Two Diabetes Meds Don’t Slow Progression of Type 2 Diabetes in Youth

pediatrician examining little girl , her mother beside her : Stock Photo View similar imagesMore from this photographer Pediatrician examining little girl , her mother beside her

Research suggests type 2 diabetes in youth may be more aggressive than in adults.

Photo: Tomwang112/Thinkstock

In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body’s ability to make insulin, according to results published June 25 in Diabetes Care.

The results come from a study of 91 youth ages 10-19, part of the larger Restoring Insulin Secretion study. To determine if early, aggressive treatment would improve outcomes, participants at 4 study sites were randomly assigned to 1 of 2 treatment groups. The first received 3 months of glargine—a long-acting insulin—followed by 9 months of metformin. The second received only metformin for 12 months. Participants were then monitored for 3 more months after treatment ended.

The RISE Pediatric Medication Study found that beta cell function—key to the body’s ability to make and release insulin—declined in both groups during treatment and worsened after treatment ended. An earlier NIH-funded study also found that type 2 diabetes progresses more rapidly in youth than previously reported in adults, despite comparable treatment.

“Only two drugs are currently approved for youth with type 2 diabetes, and we were disheartened to find that neither effectively slows disease progression,” said Dr. Ellen Leschek, program director in NIDDK’s Division of Diabetes, Endocrinology, and Metabolic Diseases. “Type 2 diabetes in youth has grown with the obesity epidemic, and we need treatments that work for kids. It’s clear from this study and others that type 2 diabetes in youth is more aggressive than in adults.”

“Our understanding of how type 2 diabetes affects youth is still maturing, and we must continue to explore treatments to ensure that these young people can live long, healthy lives,” said NIDDK director Dr. Griffin Rodgers. “These results give us another piece of the puzzle to find which therapies will treat youth with type 2 diabetes.”