ADA 2019—Youth with T2D have more rapid beta-cell deterioration than adults


  • Emily Willingham, PhD
  • Conference Reports
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Takeaway

  • Children with type 2 diabetes (T2D) have more rapid beta-cell deterioration than do adults with T2D, according to findings from the RISE (Restoring Insulin Secretion) medication studies comparing the 2. 
  • Young people in the study did not show improved or preserved function on treatment and had rapid decline with treatment withdrawal.

Why this matters

  • In a statement, the authors call the differences “quite stark.” 

Key results

  • The children in the RISE study had deteriorating beta-cell function on and off treatment.
  • Adults had improvement on treatment, although that improvement did not last with therapy withdrawal.
  • Fasting glucose was similar across all treatments, but children had higher fasting insulin and C-peptide concentrations (P<.001>
  • Adults also showed decreases in BMI starting at 6 months, but young people did not (P<.05>

Study design

  • RISE Pediatric Medication Study compared with adult study results.
  • 91 children/young people ages 10-19 enrolled, with T2D or impaired glucose tolerance (60%) for  
  • Treatments: 3 months insulin glargine then 9 months of metformin; 12 months of metformin only.
  • Funding: National Institute of Diabetes and Digestive and Kidney Diseases; ADA; Novo Nordisk A/S and other industry; others.

Limitations

  • Some difference in waist-hip ratio between adults and young people.

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