Medical ProgressTreatment Options for Type 2 Diabetes in Youth Remain Limited
Section snippets
Methods
A literature search was conducted using PubMed with librarian assistance. We included systematic reviews4, 16, 17, 18, 19, 20, 21 as well as retrospective and randomized prospective trials of medications and bariatric surgery that were limited to persons under the age of 18 years with T2D. Only research from the past 10 years was considered. We also reviewed ClinicalTrials.gov looking at active trials using the search terms “type 2 diabetes children” and “type 2 diabetes pediatrics.”
Discussion
Only 2 medications are FDA-approved for the treatment of youth with T2D: metformin and insulin. Recruitment of children and adolescents with T2D for clinical trials is limited as many clinical trials are looking for subjects who are between 10 and 17 years of age and have not been started on insulin therapy, an exclusion criterion for almost all of the T2D clinical trials. A recent commentary in Diabetes Care recommended that the age range of availability be increased from 10-17 years to
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Cited by (6)
The increasing trend of Type 2 diabetes in youth: An overview
2021, Diabetes and Metabolic Syndrome: Clinical Research and ReviewsCitation Excerpt :This, combined with the more aggressive progression of T2DM in children renders these adjustments ineffective as monotherapy to treat youth with T2DM [26]. The pharmacological treatment of youth T2DM patients focuses on controlling insulin resistance, one of the major mechanisms of T2DM [29]. Metformin is the drug of choice for youth T2DM patients, and is the only FDA approved treatment option beyond lifestyle therapy and insulin itself [25,30].
Interleukin-38 increases the insulin sensitivity in children with the type 2 diabetes
2020, International ImmunopharmacologyCitation Excerpt :The pathophysiological mechanisms underlying pediatric T2DM remain largely unknown. However, insulin resistance (IR) and inflammation are two the major contributors for T2DM development [14,19–27]. However, whether these two factors are interacted with each other remains unclear in pediatric T2DM.
A comprehensive review of the FDA-approved labels of diabetes drugs: Indications, safety, and emerging cardiovascular safety data
2017, Journal of Diabetes and its ComplicationsCitation Excerpt :Moreover, even when adolescents with T2DM achieve control with the combination of metformin and insulin, many fail to maintain adequate control after several months of treatment. These outcomes indicate a more aggressive course of T2DM in adolescents compared to adults with T2DM, and therefore an urgent need to optimize therapeutic options for pediatric T2DM.16,17 Several ongoing clinical trials in pediatric patients with T2DM should provide useful safety information upon conclusion.16,17
Health care, insurance, and school policy affecting diabetes in the pediatric population
2020, Behavioral Diabetes: Social Ecological Perspectives for Pediatric and Adult Populations
J.S. is conducting clinical trials for Daichi Sankyo and Boehringer Ingelheim; and serves as an Editorial Board member for The Journal of Pediatrics. C.M. declares no conflicts of interest.