Kids with Type 2 diabetes at greater risk of developing heart, kidney problems

Children who develop Type 2 diabetes are at high risk to develop heart, kidney and eye problems faster and at a higher rate than people who acquire Type 2 diabetes as adults, a new study has found.

"Once these kids have Type 2 diabetes, they seem to be at very high risk for early complications when compared to adults," Jane Lynch, M.D., professor of pediatric endocrinology in the School of Medicine at The University of Texas Health Science Center at San Antonio, said.

The study, led in San Antonio by UT Medicine pediatricians, includes 699 children and young people, with 44 San Antonio participants.

The rise in youth obesity rates has been accompanied by increasing Type 2 diabetes rates in young people.

"It's really a public health issue," Dr. Lynch, who is principal investigator in the San Antonio arm of the study, said.

There are many unanswered questions and few guidelines for treatment of youth with early onset Type 2 diabetes, she said.

Type 2 diabetes should not be confused with Type 1 diabetes, formerly called juvenile diabetes.

Of the participants from the national TODAY diabetes study, more than a third required medication for hypertension or kidney disease 3.9 years after they had joined the study.

In the study, 699 adolescents were randomized into three groups that received metformin, metformin plus rosiglitazone, or metformin plus intensive lifestyle intervention.

While the children on the combined drugs did the best of the three groups, Dr. Lynch said, all did poorly.

The researchers were particularly disappointed that the intensive lifestyle intervention group did not do better.

The rate of deterioration of beta cell function in youth was almost four times higher than in adults, researchers found, noting a 20-35 percent decline in beta cell function per year on average, compared to 7-11 percent for adults. Beta cells store and release insulin.

It does not make things easier that these adolescents with early onset T2 diabetes have a tough time managing complex health problems.

The study is published online in the journal Diabetes Care.