Standard type 2 diabetes treatments may not improve the condition in youth

A parent testing a child's finger with a blood glucose meter.

Taking insulin or the most commonly used drug for type 2 diabetes, metformin, failed to either delay or effectively treat the condition in youth, according to a study led by a Yale researcher.

In the study, known as the Restoring Insulin Secretion (RISE) Pediatric Medication Study, principal investigator Sonia Caprio and her co-authors investigated the effect of two interventions for pre-diabetes or diabetes in youth aged 10 to 19. The children and teens either took injections of insulin for three months, followed by metformin for a year, or metformin alone. During the 15-month study period, the researchers assessed blood sugar levels of study participants as well as the function of their beta cells, which store and release insulin in order to maintain healthy blood sugar.

The research team found that the treatments failed to slow or stop the progression of type 2 diabetes in either group. The functioning of the youths’ beta cells continued to deteriorate despite the therapies, which have been shown to treat type 2 diabetes effectively in adults, the researchers said.

While the finding may not apply to every youth with type 2 diabetes, it is a wake-up call for researchers because there is no other FDA-approved medication to treat the disease in young people. The lack of effectiveness may be due to the more aggressive nature of the disease in youth, Caprio noted.

The incidence of type 2 diabetes is rising in adolescents,” she said. “Yet we are in a very poor position because we don’t know how best to treat it.” Newer medications that target insulin sensitivity, or resistance to insulin, in youth may be needed.

Read the study, and additional RISE research, published in Diabetes Care.

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