April 30, 2012 in Nation/World

Study: Heavy teens have trouble managing diabetes

Results point out need for ‘eat less, move more’ culture
Alicia Chang Associated Press
 
Fast facts

• About 215,000 Americans under age 20 have diabetes.

• Type 1 diabetes occurs when the body can’t make insulin.

• Type 2 is related to obesity and occurs when the body can’t use insulin properly.

• About 3,600 youths are diagnosed with Type 2 diabetes every year. Minorities are disproportionately affected.

• Teens can lower their risk of Type 2 diabetes by maintaining a healthy weight, being more active and eating healthy foods.

• If diabetes is not controlled, it can lead to serious problems including vision loss, nerve damage, kidney failure, limb amputation – even heart attacks and strokes.

• A third of teens are obese or overweight, putting them at risk of Type 2.

LOS ANGELES – New research sends a stark warning to overweight teens: If you develop diabetes, you’ll have a very tough time keeping it under control.

A major study, released Sunday, tested several ways to manage blood sugar in teens newly diagnosed with diabetes and found that nearly half of them failed within a few years and 1 in 5 suffered serious complications. The results spell trouble for a nation facing rising rates of “diabesity” – Type 2 diabetes brought on by obesity.

The federally funded study is the largest look yet at how to treat diabetes in teens. Earlier studies mostly have been in adults, and most diabetes drugs aren’t even approved for youths. The message is clear: Prevention is everything.

“Don’t get diabetes in the first place,” said Dr. Phil Zeitler of the University of Colorado Denver, one of the study leaders.

A third of American children and teens are overweight or obese. They are at higher risk of developing Type 2 diabetes, in which the body can’t make enough insulin or use what it does make to process sugar from food. Until the obesity epidemic, doctors rarely saw children with Type 2 diabetes. The more common kind of diabetes in children is Type 1, which used to be called juvenile diabetes.

Doctors usually start Type 2 treatment with metformin, a pill to lower blood sugar. If it still can’t be controlled, other drugs and daily insulin shots may be needed. The longer blood sugar runs rampant, the greater the risk of suffering vision loss, nerve damage, kidney failure, limb amputation – even heart attacks and strokes.

The goal of the study was simple: What’s the best way for teens to keep diabetes in check?

The study involved 699 overweight and obese teens recently diagnosed with diabetes. All had their blood sugar normalized with metformin, then were given one of three treatments to try to maintain that control: metformin alone, metformin plus diet and exercise counseling, or metformin plus a second drug, Avandia.

After nearly four years, half in the metformin-only group failed to maintain blood sugar control. The odds were a little better for the group that took two drugs but not much different for those in the lifestyle group.

Even so, Zeitler said doctors would not recommend this combination drug therapy because Avandia has been linked to higher risk of heart attacks in adults. Those risks became known after this study had started.

Another study leader from Children’s Hospital Los Angeles, Dr. Mitchell Geffner, agreed that Avandia can’t be recommended for teens, but said the study makes clear they will need more than metformin to control their disease.

“A single pill or single approach is not going to get the job done,” he said.

Among all the teens in the study, 1 in 5 had a serious complication such as very high blood sugar, usually landing them in the hospital.

The results were published online Sunday by the New England Journal of Medicine and presented at a pediatric meeting in Boston. The National Institutes of Health funded the study and drug companies donated the medications.

The “discouraging” results point to the need to create “a healthier ‘eat less, move more’ ” culture to help avoid obesity that contributes to diabetes, Dr. David Allen of the University of Wisconsin School of Medicine and Public Health wrote in an accompanying editorial.

© Copyright 2012 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


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