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A press release from the American Sessions Conference highlighted the differences between the disease characteristics in adults and adolescents with a type 2 diabetes diagnosis [1
9659004] Over the past two decades, the prevalence of a type 2 diabetes diagnosis has increased in North American adolescents. From 2002 to 2012, the rate of new diabetes diagnoses was increased in the US The diagnoses of type 2 diabetes in adolescence Several patients under the age of 20 years are diagnosed with type 2 diabetes and prediabetes and need a blood glucose control treatment
Diabetes is a chronic disease condition in which the beta cells in the pancreas and those of these Cells secreted insulin become dysfunctional and blood sugar stays high. Steady high blood sugar can have many long-term consequences n have as cardiovascular and kidney disease.
Diabetics can produce and release more insulin than diabetic adults
Recent studies have shown that diabetic adolescents seem to produce and deliver more insulin from pancreatic beta cells than diabetic adults in response to high blood sugar levels. Insulin from children with type 2 diabetes diagnosis is also less functional. Two recent studies used different methods to identify the differences between the characteristics of diabetes in adolescents and in adults. In a third study, the researchers tested the responses of young diabetic patients to traditional diabetes medications. These findings were recently discussed in a press release from the Scientific Sessions Conference of the American Diabetes Association in June 2018.
In the first study, the researchers gave pediatric and adult diabetic or prediabetic participants a continuous intravenous glucose dose and tested how well the pancreas responded. The researchers also tested how well the insulin released by the pancreas controls the rise in blood sugar. In the second study, participants were given a high-concentration sugary drink and their blood glucose levels were monitored.
Diabetics need more insulin than diabetic adults to lower blood sugar
The results of these two studies revealed two main differences between a type 2 diabetes diagnosis in children and adults. The pancreatic beta cells in a pediatric population respond to an increase in blood sugar through the release of large amounts of insulin compared to an adult with diabetes or prediabetes. In addition, the insulin released from the pancreas in diabetic youth is less sensitive, so more insulin is needed to bring the blood sugar down to a normal level. It is clear from these studies that a type 2 diabetes diagnosis could be more severe in children and more rapid in adult patients than the same diagnosis.
With these differences in the characteristics of the disease, the researchers tested the responses of adolescents and adults with diabetes to traditional medications. Both metformin and insulin improved pancreatic beta cell function in adults with diabetes
Adolescents with prediabetes or type 2 diabetes did not respond to treatment
The researchers separated their young diabetic or prediabetic patients into two groups. One group received a three-month course of insulin followed by metformin for 9 months and a second group received one year of metformin treatment. Both treatment groups did not respond to the treatment. Surprisingly, three months after the end of treatment, patients' beta cells were even less responsive. This shows the rapid progression of the disease in adolescence.
These three studies show that a type 2 diabetes diagnosis in children must be treated differently than the same disease in adult patients. More clinical trials are needed to find effective treatments for diabetic adolescents, as conventional medicines are insufficient to ensure glycemic control.
Written by Jessica Caporuscio, PharmD
(1) American Diabetes Association. Metformin alone or in combination with insulin does not improve or improve beta cell function in adolescents with impaired glucose tolerance or newly diagnosed type 2 diabetes. 2018. http://www.diabetes.org
(2) Brutsaert, EF. Diabetes Mellitus (DM). Merck Manual Professional Version. 2017. https://www.merckmanuals.com
(3) National Institutes of Health. The rate of newly diagnosed cases of type 1 and type 2 diabetes is increasing in children and adolescents. 2017. https://www.nih.gov