Differences in Type 2 Diabetes Among Youth and Adults

Overview of Increasing Prevalence

A recent press release from the American Diabetes Association’s Scientific Sessions Conference has emphasized the distinct characteristics of type 2 diabetes in both adults and youth. Over the past twenty years, the diagnosis of type 2 diabetes among North American youth has risen significantly. From 2002 to 2012, the United States saw an increase of 4.8% in new type 2 diabetes diagnoses in this age group, leading to a growing number of individuals under 20 being diagnosed with type 2 diabetes and prediabetes, necessitating treatment for blood sugar regulation.

Understanding Diabetes

Diabetes is a chronic condition characterized by faulty beta cells in the pancreas and inadequate insulin production, resulting in elevated blood sugar levels. Persistently high blood sugar can lead to severe long-term health issues, including cardiovascular and kidney diseases.

Insulin Production Differences

Youth vs. Adults in Insulin Response

Recent studies indicate that youth with diabetes tend to produce and release more insulin from their pancreatic beta cells compared to adults in response to high blood sugar levels. However, the insulin produced by children with type 2 diabetes is often less effective. These findings were shared at the American Diabetes Association’s Scientific Sessions Conference in June 2018, based on three separate studies exploring the variations in diabetes characteristics between youth and adults.

Methodologies of the Studies

In the first study, researchers administered a continuous intravenous glucose dose to both pediatric and adult participants, assessing the pancreas’s response and the effectiveness of insulin in controlling blood sugar increases. The second study involved participants consuming a concentrated sugary beverage while monitoring their blood sugar levels.

Insulin Requirements in Diabetic Youth

Key Findings from the Studies

The outcomes of these studies highlighted two critical distinctions in type 2 diabetes diagnoses between children and adults. Pediatric patients exhibited a more substantial release of insulin in response to increased blood sugar levels than their adult counterparts. Additionally, the insulin produced in youth was less sensitive, necessitating higher doses to normalize blood sugar levels. This suggests that type 2 diabetes in children may be more severe and progress at a faster rate compared to adults.

Traditional Medication Response

Given these differences, researchers investigated how youth and adults with diabetes respond to standard treatments. Both metformin and insulin have been shown to enhance pancreatic beta-cell function in adults.

Treatment Outcomes for Youth

The research categorized young diabetic or prediabetic patients into two treatment groups. One group received insulin for three months followed by metformin for nine months, while the second group was treated with metformin alone for one year. Unfortunately, both groups exhibited a lack of responsiveness to treatment, and alarmingly, three months post-treatment, the beta cells of these patients became even less responsive. This underscores the rapid progression of type 2 diabetes in youth.

Conclusion and Future Directions

These three studies illustrate the necessity for a tailored approach when treating type 2 diabetes in children compared to adults. There is an urgent need for further clinical research to identify effective treatment options for youth with diabetes, as existing medications appear inadequate for managing blood sugar levels effectively.

References

(1) American Diabetes Association. Metformin Alone or Combined with Insulin Does Not Improve or Preserve Beta-Cell Function in Youth with Impaired Glucose Tolerance or Newly Diagnosed Type 2 Diabetes. 2018. http://www.diabetes.org
(2) Brutsaert, EF. Diabetes Mellitus (DM). Merck Manual Professional Version. 2017. https://www.merckmanuals.com
(3) National Institutes of Health. Rates of new diagnosed cases of type 1 and type 2 diabetes on the rise among children, teens. 2017. https://www.nih.gov