Study: Complications Abound for Teens with Type 2 Diabetes

It was once called adult-onset diabetes, but not anymore. Type 2 diabetes is increasing among children and teens, and so are the potentially life-threatening complications that come with the disease, a review of the research suggests.

There is not yet a clear picture of the impact of type 2 diabetes on young people. But the research that has been done suggests a high incidence of serious co-conditions, including high blood pressure, high cholesterol, and kidney and eye disease.

"The early onset of type 2 diabetes is bringing with it the early onset of the typical complications," review co-author Philip Zeitler, MD, of the University of Colorado, Denver, tells WebMD.

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The obesity epidemic has spurred an epidemic of type 2 diabetes in the U.S. among all age groups.

Heart disease, nerve disorders, kidney disease, and eye disease are common, long-term complications of type 2 diabetes in adults.

There are no nationwide figures on type 2 diabetes incidence in children and teens, but it is clear that the numbers are rising.

One recent study found a 176 percent increase in hospitalizations due to type 2 diabetes among children between 1997 and 2003, compared with a 15 percent increase in hospitalizations for type 1 diabetes, says NYU pediatrician Rhonda Graves, MD.

According to Graves, researchers from New York University School of Medicine reported that hospitalized children with type 2 diabetes had slightly longer hospital stays and more health problems than hospitalized children with type 1 diabetes.

"Type 2 diabetes is increasingly becoming a pediatric disease with serious complications just like adult-onset disease," Graves tells WebMD.

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More Research Needed

The new analysis, published May 26 in The Lancet, highlights the importance of gaining a better understanding of the progression of type 2 diabetes in the young, Zeitler says.

The limited data suggest that children and teens with type 2 diabetes develop complications more quickly than children and teens with type 1 disease.

There is also some evidence that children and teens with type 2 diabetes are not as compliant with treatments as adults and are not being treated as aggressively, Zeitler says.

"One problem is that we have no guidelines about how to use the diabetes drugs we have in children and teens," he says.

A report earlier this week linking the widely prescribed diabetes drug Avandia to an increased risk of heart attacks and possibly death underscores the need for more research on the long-term safety of diabetes medications.

"Young people with diabetes will, in all likelihood, be on these drugs for decades," Zeitler notes.

He cites the case of an 18-year-old patient who has had type 2 diabetes for four years -- a "very bright young man," says Zeitler, who dreams of going to medical school.

"He has terrible hypertension and cholesterol and is in the early stages of kidney disease," he says. "He is on as many drugs as most people's grandmothers, and the reality is he may or may not make it to age 35 or 40."

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This article was reviewed by Louise Chang, MD.

SOURCES: Pinhas-Hamiel, O. The Lancet, May 26, 2007; vol 369: pp 1823-1831. Philip Zeitler, MD, division of endocrinology, associate professor of pediatrics, University of Colorado, Denver. Pihoker, Current Diabetes Reports, 2006; vol 6: pp108-112. Rhonda Graves, MD, pediatrician, NYU School of Medicine. Pediatric Academic Societies meeting, Toronto, May 5-8, 2007.