Until two decades ago, children and adolescents were automatically assumed to have insulin-dependent type 1 diabetes. However, type 2 diabetes emerged as a “new type” of childhood diabetes in the 1990s in association with the epidemic of childhood obesity. It quickly became apparent that this new pediatric disease disproportionally affected disadvantaged minority children and was associated with comorbidities that increased the risk of future cardiovascular disease.
After more than 20 years, the optimal approach to the treatment of childhood type 2 diabetes remains largely unknown. Besides insulin, metformin remains the only other antidiabetic medication that is approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for use in youth with type 2 diabetes. Glimepiride and rosiglitazone failed noninferiority tests versus metformin as initial monotherapy in company-sponsored clinical trials. While the primary study results of the randomized phase of the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) study showed that combination therapy with metformin plus rosiglitazone was more effective than metformin plus intensive lifestyle intervention and metformin alone (1), rosiglitazone will not be used with any frequency in young patients with type 2 diabetes because of concerns about the cardiovascular and other adverse effects of this class of medications. Once again, pediatric diabetes practitioners are left with just metformin and insulin for adolescents with type 2 diabetes.
Why haven’t glucagon-like peptide 1 (GLP-1) agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors that have been approved for use in adults with type 2 diabetes been approved for the treatment of adolescents …
Full Text: http://care.diabetesjournals.org/
You can view more related articles to the TODAY study if you scroll down to bottom of the page at the above link.
Graham
4 comments:
Hi everyone. Tonight on channel ABC in Australia, on a science show "Catalyst" the report is on the con of statin drugs and how carbohydrates cause heart disease. If you don't live in Australia, you can watch it after 8.00pm our time on the internet.
Go to http://www.abc.net.au/iview/ and search for the program CATALYST to watch.
I predict thousands of Australians will be fronting up to their doctor the next day, asking for an explanation as to why they have been put on statins! It's going to be very interesting.
This is a wonderful post! Thanks for sharing your knowledge about Diabetes with us.for more info please visitOkulista Wroclaw
Many thanks for this Lisa.
Graham has just put this up on the blog with a mention to Dr Kendrick
It's good to share and spread the word.
All the best Jan
Type 2 diabetes amongst the young is growing alarmingly. Which makes it ever more important to spread the word about the benefits of a low carb high fat diet, of course some may say I'm biased! BUT I know the difference this can make to a type 2 diabetic, I'm married to one and have many diabetic friends, whose blood sugar levels have not only been reduced but in many cases nil or minimal medication is now needed. Benefits can be gained if only a change in diet is tried so the individual can see for themselves the advantages it can bring.
All the best Jan
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