Two drugs pack a harder punch for type 2 diabetes

[Posted: Mon 30/04/2012 by Gillian Tsoi www.irishhealth.com]

Two drugs are better than one when it comes to treating type 2 diabetes in young people, according to a new study.

Scientists in the US have discovered that a combination of the two diabetes drugs, metformin and rosiglitazone, is more effective than using metformin alone.

The findings arose from the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study - the first major study to compare treatments for type 2 diabetes in young people.

For TODAY, doctors focused on 699 overweight youths between the ages of 10 and 17, who had type 2 diabetes.

They were divided into three groups: the first took metformin alone; the second took metformin and rosiglitazone together; and the third took metformin in addition to changing their lifestyle dramatically to aid weight loss.

The study found that treatment with metformin alone was inadequate for maintaining long-term blood glucose control in over half (51%) of the youths.

Meanwhile, those who combined the two drugs, and those who took metformin and added lifestyle changes, had better results when it came to controlling blood sugar at normal levels.

However, the combination of metformin and rosiglitazone still failed to help more than a third of the patients who took it.

"We are learning that type 2 diabetes is a more aggressive disease in youth than in adults and progresses more rapidly," said Professor Philip Zeitler, the pediatric endocrinologist at Children's Hospital Colorado in Aurora, who led the study.

The childhood obesity epidemic has led to the emergence of type 2 diabetes in youth. However, because the disease has been primarily an adult condition, information about how to effectively treat youth is limited, and pediatric diabetes experts have had to rely on what is known about adult treatment.

The longer a person has type 2 diabetes, the greater the likelihood of developing complications including coronary artery disease, stroke, kidney and eye disease, and nerve damage. This makes it critical for young people with type 2 diabetes to quickly achieve and sustain control of their blood glucose.

Currently, metformin is the standard treatment for children and teens with type 2 diabetes.

The experts suggest the longer-term follow up research is important to understand whether more aggressive therapy for youth with type 2 diabetes will yield long-term benefits as they move into adulthood.

TODAY was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH) and appeared in the New England Journal of Medicine.