Study Suggests Metformin Alone Not Enough To Treat Diabetic Kids
April 30, 2012

Metformin Alone Not Enough To Treat Diabetic Kids

A new study, published Sunday in the New England Journal of Medicine (NEJM), reveals that a combination treatment may be the best way to treat type 2 diabetes in children and adolescents.

In an April 29 press release, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the division of the National Institutes of Health (NIH) which funded the study, stated that a combination of the medications metformin and rosiglitazone was more effective in treating youngsters with recent-onset type 2 diabetes than metformin alone.

The study, which is called the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study, discovered that the use of rosiglitazone (Avandia) -- which is currently not an FDA-approved treatment method for children or adolescents with diabetes due to concerns over cardiovascular side effects -- was found to be more effective than monotherapy, MedPage Today Staff Writer Kristina Fiore added.

Dr. Barbara Linder of the NIDDK told Salynn Boyles of WebMD Health News that the kids "did not do as well on metformin as anticipated based on our experience in adults."

The study looked at a trio of treatment approaches (metformin alone, metformin with rosiglitazone, and metformin with intensive lifestyle changes) and analyzed the effectiveness of each in controlling blood glucose level in diabetics between the ages of 10 and 17.

Participants were randomly assigned to one of the three groups, and follow-ups conducted an average 46 months later found a 51.7% failure rate in the metformin only group, a 46.6% failure rate in the metformin plus lifestyle changes group, and just a 38.6% failure rate in the metformin and rosiglitazone group.

Boyles wrote that the findings "confirm that for many children with the disease, standard treatment with metformin alone is not enough" -- even though it is the only oral drug currently approved to treat the disease in kids -- and Linder noted, "The assumption has been that kids will do fine on metformin, but clearly that is not the case."

"Monotherapy with metformin is not adequate in many kids, and combination therapy appears to bring benefits," added co-author Dr. Phil Zeitler of the University of Colorado-Denver, in an email interview with MedPage Today. "The challenge now is to determine what that combination therapy should look like given that thiazolidinediones are not a good option."