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Type 2 Diabetes Progresses Faster in Kids, Study Finds
Date:5/24/2013

eceive one of three treatments: the drug metformin, metformin plus intensive lifestyle changes or metformin plus rosiglitazone (brand name Avandia).

At the start of the study, about 12 percent of participants had high blood pressure (hypertension). Four years later, about 34 percent had high blood pressure, and the risk was highest for males and those who were heavier, according to the report, which was published online May 23 in a special issue of the journal Diabetes Care.

Initial signs of kidney disease, called microalbuminuria, almost tripled in four years -- from 6.3 percent of the children to almost 17 percent, the study found.

Other highlights:

  • Destruction of beta cells -- the cells that produce insulin -- in children and teens occurred at a rate almost four times higher than in adults.
  • Metformin and rosiglitazone improved insulin sensitivity for the first six months of treatment. There was no change in insulin sensitivity for the patients who took metformin and made lifestyle changes, and there was a decrease in insulin sensitivity for youth on metformin alone. In adults, metformin generally improves insulin sensitivity.
  • Children and teens with higher blood sugar levels had the poorest outcomes on oral medications, and needed to begin using insulin sooner.
  • Over three years, the percentage of youth who needed medication to lower their LDL cholesterol (the bad type of cholesterol) increased from 4.5 percent to 10.7 percent. Lifestyle interventions didn't appear to help lower LDL cholesterol, although they did help lower the levels of triglycerides, another type of blood fat.
  • Eye damage occurred at a rate similar to adults. About five years after diagnosis, 13.7 percent of the youths had nonproliferative retinopathy, a condition that blocks blood vessels in the eyes.

"The rapid progression of hypertension and kidney disease was surprising," said Dr. Jane Lynch, the lead author
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