Youth With Type 2 Diabetes: Rapid Rise in Hypertension and Nephropathy

MedicalResearch.com eInterview with:

Dr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San AntonioDr. Jane L Lynch MD
School of Medicine
Pediatrics
University of Texas Health Science Center at San Antonio

MedicalResearch.com: What are the main findings of the study?

Dr. Lynch: American youth with type 2 diabetes who received the best currently available treatment and close monitoring of their diabetes experienced a more rapid progression of co-morbidities far more aggressive than what is typically seen in adults with type 2 diabetes.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Lynch: Youth with type 2 diabetes enrolled in the TODAY study developed early and rapidly progressing signs of heart and kidney disease, poor glycemic control and diabetes-related eye disease; even in the group receiving more intensive two-drug therapy, shown in previously released results to be the most effective treatment for maintenance of glycemic control.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Lynch: It is extremely important to do all we can to prevent childhood type 2 diabetes and obesity in our society and to aggressively treat those children identified with early disease.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Lynch: Many questions remain as to how we can effectively treat this population to reduce the observed rapid progression to glycemic failure (insulin requirement after oral therapy fails) or to kidney and eye complications.  This is especially challenging in the pediatric population because we currently have very limited approved medications.

Extrapolating from adult literature and data regarding type 2 diabetes adult outcomes is not an ideal approach to making these decisions.

Citation:

Rapid Rise in Hypertension and Nephropathy in Youth With Type 2 Diabetes: The TODAY clinical trial 

TODAY Study Group.

Corresponding author: Laura Pyle, lpyle@bsc.gwu.edu.
Diabetes Care. 2013 Jun;36(6):1735-41.
doi: 10.2337/dc12-2420.