U.S. study says Type 2 diabetes in youth is hard to control

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Monday, May 7, 2012

A person applying insulin treatment to self.
Image: Mr Hyde.
This algorithm applies only to the assessment for overweight and obesity and subsequent decisions based on that assessment.

US researchers have found that overweight teens diagnosed with Type 2 diabetes will face harsh struggles trying to control it in a study released April 29.

A teen with Type 2 diabetes was uncommon just 15 years ago. Today, one-third of American youth are found to be overweight or obese — and more obesity is associated with higher rates of Type 2 diabetes.

New England Journal of Medicine

The study, published in the newest issue of The New England Journal of Medicine, analyzed various methods “to manage blood sugar in overweight and obese teens newly diagnosed with diabetes and found that nearly half of them failed within a few years and one in five suffered serious complications.” The findings support an increase in national “diabesity,” which is Type 2 diabetes produced from obesity.

The study is the first in-depth examination of how to medicate teens with diabetes. The majority of previous studies have solely focused on diabetes in adults. Therefore, nearly all drugs manufactured for diabetes are not approved for youths.

The research included 699 overweight and obese teens with diabetes. The teens were prescribed one of three treatments after they were given metformin, a drug to lower blood sugar. The three groups consisted of only metformin, metformin plus diet and exercise, or metformin plus a second drug, Rosiglitazone, commonly known as Avandia.

The study discovered that after four years, “half the teens in the metformin group failed to maintain blood sugar control.” The teens that took two drugs faired slightly better, and those that took metformin incorporated with a lifestyle changed saw an insignificant difference.

According to one of the paper's authors, Dr. Phil Zeitler from the University of Colorado Denver, youths should be taking steps to prevent Type 2 diabetes.

Related study

In a related study, Dr. Mari K. Hopper has collected data over the course of two and a half years at the University of Southern Indiana. Her focus — student obesity, or specifically, the beginning stage, Insulin resistance.

Insulin resistance occurs when the body needs more insulin to keep glucose at a normal level. Eventually, insulin resistance can set the stage for Type 2 diabetes and heart disease. “Insulin resistance is real and it can be quantified and about half of insulin resistance is lifestyle and the other half is genetics,” said Hopper, assistant professor of biology. “If you are insulin resistant, then that condition can be reversed.”

Hopper’s goal is to make students aware of insulin resistance and to choose to maintain a healthy lifestyle before diabetes has the chance to set in.Hopper analyzes how the college lifestyle affects a student’s overall health. Students begin the study as a subject and are invited to come back as a student researcher. They continue to collect data on the new freshman class and on themselves. There are two cohort groups, fall 2009 and fall 2010.

“I thought when they came in as freshman they would be relatively healthy, and then they would be exposed to the college lifestyle,” Hopper said. “My hypothesis is that these students, after four years, will become more insulin resistant.”

However, Hopper said she is finding that students are beginning college not as healthy as she had anticipated. “We are already incurring about 30 percent of them being overweight or obese,” Hopper said. Diet changes, the cost of eating well, stress, not enough sleep and inadequate exercise are all factors contributing to a student’s weight gain in college, she said.

“I really thought that the college years was a critical time in reaching these students in identifying risk factors for their future health so that the behavior could be modified now,” Hopper said. Her findings suggest, health care prevention has to occur earlier in youth.


Sources

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