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Reinehr, T. et al.

Thomas Reinehr, Edith Schober, Christian L. Roth, Susanna Wiegand, Reinhard Holl,

Type 2 diabetes in children and adolescents in a 2-year follow-up: insufficient adherence to diabetes centers.

BACKGROUND/AIMS: To study the 2-year course of children and adolescents with type 2 diabetes mellitus (T2DM) in general practice to present (1) the treatment modalities, (2) patient adherence, and (3) the occurrence of comorbidities. METHODS: HBA1c, lipids, blood pressure, treatment modalities, occurrence of retinopathy and nephropathy were analyzed in 129 children and adolescents with T2DM (median age 13.4 years, 75% female) in specialized diabetes centers in Germany. RESULTS: Seventy-eight (60%) children dropped out of care after a mean of 7.1 months. Drug treatment was not stopped in any of the 64 children initially treated with antidiabetic drugs. Sixteen (12%) children were treated solely by lifestyle intervention over the 2-year course. In the 51 children with complete follow-up, median HbA1c was 7.7% at diagnosis and 6.3% after 2 years. Less than 5% of all children were treated with antihypertensive or lipid-lowering drugs, while 65% suffered from hypertension and 44% from dyslipidemia. Over the course of the disease, retinopathy was not observed, while microalbuminuria occurred in 25%. CONCLUSIONS: In general practice, many children and adolescents with T2DM were lost of follow-up. Lifestyle intervention as sole treatment was not often useful for long-term metabolic control. Dyslipidemia and hypertension were seldom treated as recommended.[1]

References

Type 2 diabetes in children and adolescents in a 2-year follow-up: insufficient adherence to diabetes centers. Reinehr, T., Schober, E., Roth, C.L., Wiegand, S., Holl, R. Horm. Res. (2008) [Pubmed]

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