Study: Children with Type 2 Diabetes have more rapid disease progression than adults

Children with Type 2 Diabetes Mellitus (T2DM) have more rapid disease progression than adults, revealed a study by Dr. Lorraine E. Levitt Katz and colleagues at The Children's Hospital of Philadelphia and the University of Pennsylvania. It has been observed that two years after diagnosis, children and adolescents with Type 2 Diabetes need increasing doses of insulin due to a rapid decline in beta cell function.

Method 

As a part of the study, the researchers observed 59 children (mean age - 14) with Type 2 Diabetes Mellitus for four years. Most of the children were African-American and thirteen of them had Diabetic Ketoacidosis (DKA) at diagnosis. The children received only metformin (up to 1000mg twice daily) for oral medication and insulin therapy was started for hemoglobin (Hb)A1c levels of 8.5% or higher. At baseline, 84% of the children needed insulin, with higher doses required in the group with Diabetic Ketoacidosis. Baseline HbA1c was 13.0% in the Diabetic Ketoacidosis group and 9.8% in the kids without DKA.

Dr. Levitt Katz and her associates found that “within the first 6 months, the HbA1c levels in both groups reached the lowest point and gradually rose after 1 year. Over 4 years, the HbA1c levels had risen with differences in the nonacidotic and Diabetic Ketoacidosis groups.” Gradually, insulin requirements began to rise after two years, and by four years all of the subjects needed higher insulin doses. The highest median dose was in the Diabetic Ketoacidosis group.

Result 

The insulin reserve over time in childhood Type 2 Diabetes Mellitus has been unknown but the researchers suspected there would be “a more rapid decline in glycemic control than has been published for adults and that this decline would be more severe for those presenting with Diabetic Ketoacidosis.” The researchers concluded that “Type 2 Diabetes in youth progresses more rapidly to insulin deficiency than in adults.”